Dexmedetomidine versus clonidine as an adjuvant to local anaesthetic in brachial plexus blocks: a metaanalysis of randomised controlled trials
Braz. J. Anesth. (Impr.)
;
73(5): 665-675, 2023. tab, graf
Article
in English
| LILACS
| ID: biblio-1520356
ABSTRACT
Abstract Objective:
This meta-analysis aimed to compare the efficacy and safety of dexmedetomidine and Clonidine as an adjuvant to local anesthetics in BPBs.Methods:
Two investigators independently searched databases to identify all RCTs comparing the efficacy and/or safety of dexmedetomidine and Clonidine as an adjuvant to local anesthetics in BPBs. All outcomes were pooled using the inverse variance method with a random-effect model. An I2 test was used to assess heterogeneity. The source of heterogeneity was explored through meta-regression. The quality of the evidence was assessed using the GRADE approach.Results:
Out of 123 full texts assessed, 24 studies (1448 patients) were included in the analysis. As compared to Clonidine, dexmedetomidine groups showed significantly longer sensory block duration (MD = 173.31; 95% CI 138.02-208.59; I2 = 99%; GRADE approach evidence high); motor block duration (MD = 158.35; 95% CI 131.55-185.16; I2 = 98%; GRADE approach evidence high), duration of analgesia (MD = 203.92; 95% CI 169.25-238.58; I2 = 99%; GRADE approach evidence-high), and provided higher grade quality of block (RR = 1.97; 95% CI 1.60-2.41 ; I2 = 0%; GRADE approach evidence moderate). The block positioning technique (regression coefficient 51.45, p = 0.005) was observed as a significant predictor of the heterogeneity in the case of sensory block duration. No significant difference was observed for the risk of hypotension (RR = 2.59; 95% CI 0.63-10.66; I2 = %).Conclusion:
Moderate to high-quality evidence suggests dexmedetomidine is a more efficacious adjuvant to local anesthetic in BPBs than Clonidine.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Brachial Plexus Block
Type of study:
Systematic reviews
Language:
English
Journal:
Braz. J. Anesth. (Impr.)
Year:
2023
Type:
Article
Affiliation country:
India
Institution/Affiliation country:
All India Institute of Medical Sciences/IN
/
B.R.D medical College/IN
/
Banaras Hindu University/IN
/
Mahamana Pandit Madan Mohan Malviya Cancer Centre/IN
/
Rajkiya Medical College/IN
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