The Efficiency And Safety Of Dexamethasone For Pain Relief Followed Lumbar Decompression And Fusion: A Systematic Review And Meta-Analysis
Abstract Background: This meta-analysis was to evaluate the safety and efficiency of dexamethasone for pain relief followed lumbar decompression and fusion.Methods: Two reviewers have independently searched 3 electronic databases (PubMed, EMBASE and Cochrane Library) up to Jun, 2019 without restrictions on language and publication. After testing for heterogeneity between studies, data were aggregated for random-effects models when necessary. The results of dichotomous outcomes were expressed as relative risks (RRs) with a 95% confidence intervals (CIs). For continuous variable, mean and standard difference (SD) were applied for assessment. Meta-analysis was performed using Stata 12.0 software.Results: Seven RCTs and one retrospective study including 958 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between groups in terms of visual analogue scale (VAS) scores at 24 hours of movement (SMD=0.44, 95% CI: 0.67 to 0.21, P < 0.001). Dexamethasone group was associated with a lower opioids consumption at 24 hours (SMD=0.601, 95% CI: 0.93 to 0.28, P < 0.001), less occurrence of nausea and vomiting (RR=0.52, 95% CI: 0.40 to 0.67, P < 0.001), shorter length of hospital stay (SMD = 0.207, 95% CI: 0.396 to 0.017, P = 0.003).Conclusion: In our meta-analysis of 8 reliable studies, we found that intravenous dexamethasone could significantly reduce postoperative pain scores and opioids consumption within the 24 hours followed lumbar decompression and fusion. Furthermore, patients could gain functional exercise early and the length of stay in hospital was significantly shorten. More researches were needed to confirm these conclusions.