Efficacy of memantine premedication in alleviating postoperative pain- A systematic review and meta-analysis
Many premedication agents with opioid-sparing properties have been used in patients undergoing various elective surgeries. Memantine is an N-methyl-D-aspartate (NMDA) receptor antagonist that has been used by many researchers as an opioid-sparing strategy. Various databases like PubMed, Scopus, Coch...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-01-01
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| Series: | Saudi Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.saudija.org/article.asp?issn=1658-354X;year=2024;volume=18;issue=1;spage=86;epage=94;aulast=Nair |
| _version_ | 1797299949674692608 |
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| author | Abhijit Nair Ujjwalraj Dudhedia Manish Thakre Nitinkumar Borkar |
| author_facet | Abhijit Nair Ujjwalraj Dudhedia Manish Thakre Nitinkumar Borkar |
| author_sort | Abhijit Nair |
| collection | DOAJ |
| description | Many premedication agents with opioid-sparing properties have been used in patients undergoing various elective surgeries. Memantine is an N-methyl-D-aspartate (NMDA) receptor antagonist that has been used by many researchers as an opioid-sparing strategy. Various databases like PubMed, Scopus, Cochrane Library, and clinicaltrials.gov were searched after registering the review protocol in PROSPERO for randomized-controlled trials (RCTs) that investigated the efficacy and safety of memantine premedication in adult patients undergoing various elective surgeries. The risk of bias (RoB-2) scale was used to assess the quality of evidence. From the 225 articles that were identified after a database search, 3 studies were included for a qualitative systematic review and a quantitative meta-analysis. The pooled analysis revealed that the use of memantine provided better pain scores at 2nd (mean difference: -0.82, 95% CI: -1.60, -0.05, P = 0.04) with significant heterogeneity (P = 0.06; I2 =71%), and 6 hours postoperatively (mean difference: -1.80, 95% CI: -2.23, -1.37, P < 0.00001), but not at 1 hour. The sedation scores at 1 hour were higher in the memantine group but comparable in the 2nd hour. The number of doses of rescue analgesia and nausea/vomiting in the postoperative period was comparable in both groups. The results of this review suggest that memantine premedication could provide better pain scores in the immediate postoperative period with acceptable adverse effects. However, the current evidence is insufficient to suggest the routine use of memantine as a premedication before elective surgeries. |
| first_indexed | 2024-03-07T22:59:05Z |
| format | Article |
| id | doaj.art-54b5cdae400040b18e707a7c182cb7d5 |
| institution | Directory Open Access Journal |
| issn | 1658-354X |
| language | English |
| last_indexed | 2024-03-07T22:59:05Z |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Anaesthesia |
| spelling | doaj.art-54b5cdae400040b18e707a7c182cb7d52024-02-22T15:28:28ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X2024-01-01181869410.4103/sja.sja_398_23Efficacy of memantine premedication in alleviating postoperative pain- A systematic review and meta-analysisAbhijit NairUjjwalraj DudhediaManish ThakreNitinkumar BorkarMany premedication agents with opioid-sparing properties have been used in patients undergoing various elective surgeries. Memantine is an N-methyl-D-aspartate (NMDA) receptor antagonist that has been used by many researchers as an opioid-sparing strategy. Various databases like PubMed, Scopus, Cochrane Library, and clinicaltrials.gov were searched after registering the review protocol in PROSPERO for randomized-controlled trials (RCTs) that investigated the efficacy and safety of memantine premedication in adult patients undergoing various elective surgeries. The risk of bias (RoB-2) scale was used to assess the quality of evidence. From the 225 articles that were identified after a database search, 3 studies were included for a qualitative systematic review and a quantitative meta-analysis. The pooled analysis revealed that the use of memantine provided better pain scores at 2nd (mean difference: -0.82, 95% CI: -1.60, -0.05, P = 0.04) with significant heterogeneity (P = 0.06; I2 =71%), and 6 hours postoperatively (mean difference: -1.80, 95% CI: -2.23, -1.37, P < 0.00001), but not at 1 hour. The sedation scores at 1 hour were higher in the memantine group but comparable in the 2nd hour. The number of doses of rescue analgesia and nausea/vomiting in the postoperative period was comparable in both groups. The results of this review suggest that memantine premedication could provide better pain scores in the immediate postoperative period with acceptable adverse effects. However, the current evidence is insufficient to suggest the routine use of memantine as a premedication before elective surgeries.http://www.saudija.org/article.asp?issn=1658-354X;year=2024;volume=18;issue=1;spage=86;epage=94;aulast=Nairacute painmemantinen-methyl-d-aspartatepostoperativepremedication |
| spellingShingle | Abhijit Nair Ujjwalraj Dudhedia Manish Thakre Nitinkumar Borkar Efficacy of memantine premedication in alleviating postoperative pain- A systematic review and meta-analysis Saudi Journal of Anaesthesia acute pain memantine n-methyl-d-aspartate postoperative premedication |
| title | Efficacy of memantine premedication in alleviating postoperative pain- A systematic review and meta-analysis |
| title_full | Efficacy of memantine premedication in alleviating postoperative pain- A systematic review and meta-analysis |
| title_fullStr | Efficacy of memantine premedication in alleviating postoperative pain- A systematic review and meta-analysis |
| title_full_unstemmed | Efficacy of memantine premedication in alleviating postoperative pain- A systematic review and meta-analysis |
| title_short | Efficacy of memantine premedication in alleviating postoperative pain- A systematic review and meta-analysis |
| title_sort | efficacy of memantine premedication in alleviating postoperative pain a systematic review and meta analysis |
| topic | acute pain memantine n-methyl-d-aspartate postoperative premedication |
| url | http://www.saudija.org/article.asp?issn=1658-354X;year=2024;volume=18;issue=1;spage=86;epage=94;aulast=Nair |
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