Effect of Intrathecal Dexmedetomidine on the Characteristics of Bupivacaine Spinal Block in Orthopaedic Surgeries

Gowda, K G Gangadhara; Hanji, S Anitha

doi:10.5958/0976-5506.2015.00140.0

Cited by 1 publication

(2 citation statements)

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“…Of the 231 articles retrieved, 31 required a further full-text screening. Of these, eight were excluded: three for incomplete data on shivering,18–20 two for non-RCTs,21,22 one for IV administration of DEX,23 one for unavailability of the full text24 and one for conference literature 25. Authors were contacted for the missing data, but we failed to receive any replies.…”

Section: Resultsmentioning

confidence: 99%

“…Fifth, on account of inconsistent sedation scales and different measuring times, most details regarding the number of events at each sedation level in the same endpoint were unavailable for extraction. lastly, the full text from Gangadhara et al24 was not available from the authors, thus, we believe that future meta-analyses can cover this shortage.…”

Section: Discussionmentioning

confidence: 99%

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<p>Subarachnoid and epidural dexmedetomidine for the prevention of post-anesthetic shivering: a meta-analysis and systematic review</p>

Jiang

Lin

et al. 2019

DDDT

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BackgroundPost-anesthetic shivering incurs discomfort to patients or even exacerbates their condition. However, no ideal drug has been well established for preventing post-anesthetic shivering. Currently, subarachnoid and epidural dexmedetomidine have demonstrated to have an anti-shivering effect.MethodsAn electronic search was conducted to identify randomized placebo-controlled trials reporting shivering and then compared subarachnoid and epidural dexmedetomidine with placebo in adults undergoing selective surgery. Data assessment and pooling were analyzed by Review Manager 5.3, STATA 15.0 and GRADE-pro 3.6 software.ResultsTwenty-two studies (1389 patients) were subjected to this meta-analysis. The incidence of post-anesthetic shivering decreased from 20.10% in the placebo group to 10.30% in the dexmedetomidine group (RR, 0.48; 95% CI, 0.39–0.59; Z=6.86, P<0.00001, I2=32%). Non-Indian, epidural-space route and cesarean subgroups indicated a better anti-shivering effect. In the subarachnoid-space route subgroup, a dosage of >5 μg showed significantly superior anti-shivering effects than that of ≤5 μg. Subarachnoid and epidural dexmedetomidine increased the incidence of bradycardia, had no impact on nausea and vomiting, shortened the onset of block and lengthened the duration of block and analgesia. However, its effect on hypotension and sedation remained uncertain. The overall risk of bias was relatively low. The level of evidence was high, and the recommendation of voting results was strong.ConclusionDexmedetomidine as a subarachnoid and epidural adjunct drug could decrease the incidence of post-anesthetic shivering in a dose-dependent manner. However, caution should be taken in patients with original bradycardia.

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