Efficacy and Safety of Dexmedetomidine as an Adjuvant in Epidural Analgesia and Anesthesia: A Systematic Review and Meta-analysis of Randomized Controlled Trials

@article{Zhang2016EfficacyAS,
  title={Efficacy and Safety of Dexmedetomidine as an Adjuvant in Epidural Analgesia and Anesthesia: A Systematic Review and Meta-analysis of Randomized Controlled Trials},
  author={Xu Zhang and Dong Wang and Min Shi and Yuanguo Luo},
  journal={Clinical Drug Investigation},
  year={2016},
  volume={37},
  pages={343-354}
}
Background and ObjectiveSeveral clinical trials have examined and indicated the usefulness of epidural dexmedetomidine therapy. However, there has been no systematic analysis of the findings of these trials to date. We undertook this systematic review and meta-analysis to investigate the efficacy and safety of epidural dexmedetomidine adjunctive therapy in different surgical procedures.Materials and MethodsWe searched EMBASE, PubMed, the Cochrane Library, and the Clinical Trials.gov database to… 
Effect of dexmedetomidine on hemodynamics in patients undergoing hysterectomy: a meta-analysis and systematic review
Objective We conducted a meta-analysis and systematic review to evaluate the effects of dexmedetomidine on the hemodynamics of patients undergoing hysterectomy. Methods We searched the Medline,
Effect of Epidural Dexmedetomidine as an Adjuvant to Local Anesthetics for Labor Analgesia: A Meta-Analysis of Randomized Controlled Trials
  • Nijuan Li, Li Hu, Chunping Li, Xuelin Pan, Yong Tang
  • Medicine
    Evidence-based complementary and alternative medicine : eCAM
  • 2021
TLDR
Epidural dexmedetomidine has the potential to offer a better analgesic effect than placebo, similar labor pain control to opioids, and has no definite adverse effects on the parturient or fetus, but more high-quality studies are needed to confirm these conclusions.
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TLDR
Dexmedetomidine 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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Outcomes of the systematic review showed that DEX has advantages in improving patients’ postoperative sleep quality and combined with the use of general anesthetic, DEX provides a reliable choice for procedural sedation.
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TLDR
Dexmedetomidine is superior to sufentanil in analgesic effect and duration in first-stage labor during epidural analgesia when combined with 0.1% ropivacaine.
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TLDR
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TLDR
Dexmedetomidine combined with ropivacaine may provide better postoperative analgesia and sedative effect in patients undergoing thoracic surgery with fewer side effects and is superior to sufentanil in analgesic effect during post operative analgesia after thoracotomy.
The effect of dexmedetomidine and midazolam on combined spinal-epidural anesthesia in patients undergoing total knee arthroplasty
TLDR
Intravenous injection of dexmedetomidine, rather than midazolam, for procedural sedation is associated with prolonged sensory block, with comparable incidences of adverse events during CSE anesthesia.
The impact of dexmedetomidine added to ropivicaine for transversus abdominis plane block on stress response in laparoscopic surgery: a randomized controlled trial
TLDR
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References

SHOWING 1-10 OF 69 REFERENCES
Comparative study for better adjuvant with ropivacaine in epidural anesthesia
Background: Better adjuvants for epidural analgesia are still evolving. Dexmedetomidine that is alpha-2 agonist can be used as an adjuvant in epidural analgesia and anesthesia. Aims: The aim of this
The efficacy and safety of epidural dexmedetomidine and clonidine with bupivacaine in patients undergoing lower limb orthopedic surgeries
TLDR
Dexmedetomidine is a superior neuraxial adjuvant to bupivacaine when compared to clonidine for early onset of analgesia, superior intra-operative analgesIA, stable cardio-respiratory parameters, prolonged postoperative analgesia and providing patient comfort.
Neurocognitive Dysfunction Risk Alleviation With the Use of Dexmedetomidine in Perioperative Conditions or as ICU Sedation
TLDR
Dexmedetomidine use in the perioperative conditions or as ICU sedation is associated with lower risk of neurocognitive dysfunction and there can be some impact of neuroCognitive assessment method, drug interactions, and clinical heterogeneity on the overall outcomes of this meta-analysis.
Dexmedetomidine as a Sedative Agent in Critically Ill Patients: A Meta-Analysis of Randomized Controlled Trials
TLDR
This meta-analysis of randomized controlled studies suggests that dexmedetomidine could help to reduce ICU stay and time to extubation, in critically ill patients even if high heterogeneity between studies might confound the interpretation of these results.
Comparative evaluation of ropivacaine versus dexmedetomidine and ropivacaine in epidural anesthesia in lower limb orthopedic surgeries
TLDR
Epidural Dexmedetomidine as an adjuvant to Ropivacaine is associated with prolonged sensory and motor block, hemodynamic stability, prolonged postoperative analgesia and reduced demand for rescue analgesics when compared to plain Ropvacaine.
Dexmedetomidine and clonidine in epidural anaesthesia: A comparative evaluation
Efforts to find a better adjuvant in regional anaesthesia are underway since long. Aims and objectives are to compare the efficacy and clinical profile of two α-2 adrenergic agonists, dexmedetomidine
Evaluation of low-dose dexmedetomidine and neostigmine with bupivacaine for postoperative analgesia in orthopedic surgeries: A prospective randomized double-blind study
TLDR
Epidurally administered dexmedetomidine and neostigmine exhibit synergism in analgesic action and the incidence of drug-related side-effects was low in this study.
Comparative analysis of epidural bupivacaine versus bupivacaine with dexmedetomidine for vaginal hysterectomy
TLDR
E epidural dexmedetomidine 0.5 µg/kg is a good adjuvant providing early onset of sensory and motor block, adequate sedation and prolonged postoperative analgesia with minimal side-effects.
Comparative study of epidural morphine and epidural dexmedetomidine used as adjuvant to levobupivacaine in major abdominal surgery
Abstract Background A lot of researches have been done to find an adjuvant in regional anesthesia that inhibits pain without any side effects. Aim This study was conducted to evaluate the onset,
Dexmedetomidine as an Adjuvant to Pre-Emptive Caudal Epidural Ropivacaine for Lumbosacral Spine Surgeries.
TLDR
Results suggest that inj dexmedetomidine is an effective additive to inj ropivacaine for pre-emptive caudal epidural analgesia in lumbosacral spine surgeries.
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