Effects of Intravenous and Intrathecal Dexmedetomidine in Spinal Anesthesia: A Meta-Analysis

Authors

  • Xiao-Yin Niu,

    1. Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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  • Xi-Bing Ding,

    1. Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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  • Ting Guo,

    1. Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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  • Ming-Hui Chen,

    1. Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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  • Shu-Kun Fu,

    1. Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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  • Quan Li

    Corresponding author
    1. Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
    • Correspondence

      Q. Li, M.D., Ph.D., Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Middle Road, Shanghai 200072, China.

      Tel.: +86-138-16262446;

      Fax: +86-21-66307531;

      E-mail: quanligene@126.com

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  • The first two authors contributed equally to this work.

Summary

Purpose

To assess the effects of dexmedetomidine on the duration of sensory and motor block, postoperative analgesia, hypotension, bradycardia, and side effects in patients undergoing spinal anesthesia.

Methods

Two researchers searched MEDLINE, EMBASE, and the Cochrane controlled trial register independently for randomized controlled trials comparing dexmedetomidine with a placebo without any language restrictions.

Results

A total of 412 patients from eight trials were included in this study. The results revealed that dexmedetomidine was statistically significant in prolonging the duration of sensory block (mean difference, MD = 73.55; 95% CI, [55.69, 91.40] P < 0.00001, I2 = 89%) and motor block (MD = 59.11; 95% CI, [29.58, 88.65] P < 0.00001, I2 = 91%) and the time to first request for postoperative analgesia (MD = 245.77, 95% CI, [143.53, 348.00] P < 0.00001, I2 = 98%). The occurrence of hypotension (OR = 0.60, 95% CI, [0.3–1.23], P = 0.40, I2 = 3%) and side effects (OR = 0.9, 95% CI, [0.36–2.22], P = 0.88, I2 = 0%) was not significantly different between dexmedetomidine and placebo. However, dexmedetomidine was associated with more frequent bradycardia requiring atropine (OR = 7.55; 95% CI, [2.76–20.63], P = 0.63, I2 = 0%).

Conclusions

This meta-analysis has shown that dexmedetomidine prolonged the duration of spinal anesthesia and improved postoperative analgesia and did not increase the incidence of hypotension and adverse events, but needs more atropine to reverse bradycardia.

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