Efficacy of dexmedetomidine as an adjuvant in transverse abdominal plane blocks for cesarean section pain management: A systematic review and meta-analysis.

Postoperative pain management is a key component of care for women undergoing cesarean section. Although the use of dexmedetomidine (DMD) as an adjuvant to local anesthetics in transverse abdominal plane (TAP) blocks has been investigated, its conclusive evidence on its efficacy and safety remains unclear. A standardized data extraction form, under the guidance of the PRISMA protocol, was devised for selecting relevant studies across eight databases, without restrictions on the publication period. In most of the eight studies reviewed, the group receiving DMD demonstrated a significant extension of the duration of analgesia compared to the control group [mean difference (MD) = -3.37 hours, 95% confidence interval (CI) = -6.10 to -0.65 hours, Z = 2.43, P = 0.02]. The DMD group also showed a significant decrease in Visual Analogue Scale pain scores (MD = -1.38, 95% CI = -2.52 to -0.24, Z = 2.37, P = 0.02) in comparison to the control group. Nevertheless, significant heterogeneity was observed across the studies, potentially due to differences in study design, patient demographics, and dosing protocols, among other factors. The results of this meta-analysis indicate that DMD could be an effective adjuvant to local anesthetics in TAP blocks, potentially improving postoperative pain management and decreasing the need for additional analgesia. Nevertheless, the considerable heterogeneity among the studies warrants cautious interpretation of these results.