Dexmedetomidine versus clonidine as an adjuvant to local anaesthetic in brachial plexus blocks : a meta-analysis of randomised controlled trials
Copyright © 2022 Sociedade Brasileira de Anestesiologia. Published by Elsevier España S.L.U. All rights reserved..
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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:73 |
|---|---|
| Enthalten in: |
Brazilian journal of anesthesiology (Elsevier) - 73(2023), 5 vom: 01. Sept., Seite 665-675 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Bajpai, Vijeta [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Brachial plexus block |
|---|
| Anmerkungen: |
Date Revised 03.10.2023 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1016/j.bjane.2022.07.005 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM344374475 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM344374475 | ||
| 003 | DE-627 | ||
| 005 | 20231226022624.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.bjane.2022.07.005 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1147.xml |
| 035 | |a (DE-627)NLM344374475 | ||
| 035 | |a (NLM)35917846 | ||
| 035 | |a (PII)S0104-0014(22)00085-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Bajpai, Vijeta |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Dexmedetomidine versus clonidine as an adjuvant to local anaesthetic in brachial plexus blocks |b a meta-analysis of randomised controlled trials |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 03.10.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2022 Sociedade Brasileira de Anestesiologia. Published by Elsevier España S.L.U. All rights reserved. | ||
| 520 | |a OBJECTIVE: This meta-analysis aimed to compare the efficacy and safety of dexmedetomidine and clonidine as an adjuvant to local anesthetics in BPBs | ||
| 520 | |a 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 | ||
| 520 | |a 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 = %) | ||
| 520 | |a CONCLUSION: Moderate to high-quality evidence suggests dexmedetomidine is a more efficacious adjuvant to local anesthetic in BPBs than clonidine | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Brachial plexus block | |
| 650 | 4 | |a Clonidine | |
| 650 | 4 | |a Dexmedetomidine | |
| 650 | 4 | |a Meta-analysis | |
| 700 | 1 | |a Patel, Tejas K |e verfasserin |4 aut | |
| 700 | 1 | |a Dwivedi, Priyanka |e verfasserin |4 aut | |
| 700 | 1 | |a Bajpai, Amrita |e verfasserin |4 aut | |
| 700 | 1 | |a Gupta, Astha |e verfasserin |4 aut | |
| 700 | 1 | |a Gangwar, Pradeepika |e verfasserin |4 aut | |
| 700 | 1 | |a Singh, Yashpal |e verfasserin |4 aut | |
| 700 | 1 | |a Agarwal, Richa |e verfasserin |4 aut | |
| 700 | 1 | |a Kishore, Surekha |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Brazilian journal of anesthesiology (Elsevier) |d 2013 |g 73(2023), 5 vom: 01. Sept., Seite 665-675 |w (DE-627)NLM225306182 |x 2352-2291 |7 nnns |
| 773 | 1 | 8 | |g volume:73 |g year:2023 |g number:5 |g day:01 |g month:09 |g pages:665-675 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.bjane.2022.07.005 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 73 |j 2023 |e 5 |b 01 |c 09 |h 665-675 | ||