ABSTRACT
Effective control of labor pain is critical to the birthing experience. Dexmedetomidine is an alternative adjunct to labor analgesia without the risk of opioid-related adverse effects. The purpose of this study was to examine the efficacy and safety of neuraxial dexmedetomidine versus neuraxial opioids in labor analgesia. PubMed, CINAHL, Cochrane, Google Scholar, and grey literature were searched for evidence. Risk ratio and mean difference (MD) were used to estimate outcomes. The quality of evidence was assessed using the Risk of Bias and GRADE system. Sixteen studies including 1,669 patients were analyzed. Compared with opioids, dexmedetomidine prolonged the duration of analgesia (MD, 47.58 minutes; 95% confidence interval [CI], 1.57 to 93.58; P = .04), reduced pain score (MD, -0.71; 95% CI, -1.17 to -0.24; P = .003), and shortened the onset of analgesia (MD, -1.14 minutes; 95% CI, -1.93 to -0.35; P = .005). Dexmedetomidine did not affect the duration of first and second stages of labor, number of spontaneous, assisted, and cesarean delivery. Additionally, dexmedetomidine had little to no effects on maternal and neonatal outcomes. Neuraxial dexmedetomidine is more favorable than neuraxial opioids for labor analgesia. Extrapolation of the findings to clinical practice should take into considerations the review limitations.
Subject(s)
Analgesia , Dexmedetomidine , Pregnancy , Female , Infant, Newborn , Humans , Analgesics, Opioid/adverse effects , Dexmedetomidine/therapeutic use , Randomized Controlled Trials as Topic , AnalgesicsABSTRACT
Introducción: los objetos de aprendizaje son recursos digitales reutilizables con propósito educativo. Están formados por al menos tres componentes internos: contenidos, actividades de aprendizaje y elementos de contextualización. Objetivo: elaborar un repositorio de objeto de aprendizaje, sustentado en web, que facilite el acceso a estos objetos para mejorar el autoaprendizaje de los estudiantes de medicina, en la actividad profesional como futuro trabajador de la salud. Método: se realizó un estudio de desarrollo en la Universidad de Ciencias Médicas de Granma, se diagnosticó la utilización por docentes y estudiantes de estos recursos. Se utilizaron documentos y se analizaron las condiciones para la utilización de los objetos en la enseñanza, los datos se resumieron a partir de la estadística descriptiva. Resultados: el repositorio de objeto de aprendizaje es accesible desde la red de salud donde se accede a la explicación y correcto procedimiento de contenidos médicos. Conclusiones: se elaboró un repositorio de objetos de aprendizaje, sustentado en web, que facilita el acceso a estos y mejora el autoaprendizaje de estudiantes en su actividad profesional como futuro trabajador de la salud. La significación social del problema de investigación radica en que se hace necesario darle un mejor uso a las nuevas tecnologías y brindar a los usuarios de la red de salud mejores medios para el aprendizaje y visualización de procedimientos médicos(AU)
Introduction: learning objects are reusable digital resources for educational purposes. They consist of at least three internal components: contents, learning activities and contextual elements. Objective: to develop a learning object repository, supported by web that facilitates access to these objects to improve the self-learning of medical students, in professional activity as a future health worker. Method: a developmental study was carried out at the University Of Medical Sciences Of Granma; the use of these resources by teachers and students was diagnosed. We used documents and analyzed the conditions for the use of objects in teaching; the data were summarized from the descriptive statistics. Results: the learning object repository is accessible from the health network where the explanation and correct medical content procedure is accessed. Conclusions: a web-based learning objects repository was developed, which facilitates access to these and improves the self-learning of students in their professional activity as a future health worker. The social significance of the research problem is that it is necessary to give better use to new technologies and to provide users of the health network with better means for learning and visualizing medical procedures(EU)
