Perineural Dexmedetomidine Is More Effective Than Clonidine When Added to Local Anesthetic for Supraclavicular Brachial Plexus Block: A Systematic Review and Meta-analysis

Anesthesia and Analgesia
Kariem El-BoghdadlyFaraj W Abdallah

Abstract

Clonidine, an α-2 agonist, has long been used as a local anesthetic adjunct with proven efficacy to prolong peripheral nerve block duration. Dexmedetomidine, a newer α-2 agonist, has a more favorable pharmacodynamic and safety profile; however, data comparing its efficacy as an adjunct to that of clonidine are inconsistent. We sought to compare the clinical efficacy of these 2 α-2 agonists by examining their effects on peripheral nerve block characteristics for upper extremity surgery. A preliminary search found that the overwhelming majority of randomized controlled trials comparing perineural dexmedetomidine to clonidine for upper extremity surgery were in the setting of supraclavicular brachial plexus block (SCB). Therefore, we performed a systematic review and meta-analysis of randomized controlled trials comparing dexmedetomidine with clonidine as perineural adjuncts to single-injection SCB. Sensory and motor block duration and onset, analgesic duration, α-2 agonist side effects, and block complications were analyzed. Sensory block duration was designated as a primary outcome. Data were combined using random-effects modeling, and ratio-of-means was used to analyze the results. A total of 868 patients from 14 clinical studi...Continue Reading

References

Sep 1, 1979·European Journal of Pharmacology·T C SpauldingH Lal
Oct 1, 1991·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·J J EledjamJ du Cailar
Sep 1, 1986·Controlled Clinical Trials·R DerSimonian, N Laird
Mar 31, 2000·The Clinical Journal of Pain·E K BreivikE Skovlund
Sep 26, 2001·Current Opinion in Critical Care·D B CoursinG A Maccioli
Nov 22, 2001·The European Journal of Surgery = Acta Chirurgica·A A Weinbroum, R Ben-Abraham
Jul 12, 2002·Statistics in Medicine·Julian P T Higgins, Simon G Thompson
Apr 21, 2005·BMC Medical Research Methodology·Stela Pudar HozoIztok Hozo
Dec 22, 2005·Proceedings·R GertlerE N Silvius
Jun 5, 2007·The Journal of Bone and Joint Surgery. American Volume·Scott S Reuben, Asokumar Buvanendran
Dec 20, 2007·European Journal of Anaesthesiology·S KonakciT Rezanko
Jul 23, 2009·Annals of Internal Medicine·David MoherUNKNOWN PRISMA Group
Sep 15, 2009·Regional Anesthesia and Pain Medicine·Joseph M NealJohn C Rowlingson
Oct 5, 2010·Anesthesia and Analgesia·Aliye EsmaogluCemil Yildirim Turk
Mar 31, 2011·Journal of Clinical Epidemiology·Jan O FriedrichJoseph Beyene
Oct 20, 2011·BMJ : British Medical Journal·Julian P T HigginsUNKNOWN Cochrane Statistical Methods Group
Jan 10, 2012·International Anesthesiology Clinics·Robert P McGraw, Brian M Ilfeld
Nov 20, 2012·British Journal of Anaesthesia·D MarhoferM Zeitlinger
Sep 18, 2014·The Journal of Hand Surgery·Heather BaltzerSteven J McCabe
Jan 9, 2015·The Journal of Bone and Joint Surgery. American Volume·Brent GrahamMarc Swiontkowski
Apr 17, 2015·BMC Neurology·Margit Alt MurphyIlse Lamers
Jul 25, 2015·Current Opinion in Anaesthesiology·Joshua B KnightBrian A Williams

❮ Previous
Next ❯

Citations

Mar 10, 2018·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak, William L Lanier
Dec 1, 2017·Anesthesia and Analgesia·Philipp LirkGary Strichartz
Dec 2, 2017·Journal of Clinical Pharmacy and Therapeutics·E KorakiA Trikoupi
Apr 29, 2018·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Josh P MelvinKi Jinn Chin
Aug 25, 2018·Korean journal of anesthesiology·Eric S Schwenk, Edward R Mariano
Jan 30, 2018·F1000Research·Irene SellbrandtJan G Jakobsson
Jan 24, 2019·Der Anaesthesist·T Volk, C Kubulus
Jun 1, 2020·Regional Anesthesia and Pain Medicine·Johnny Wei BaiVincent Chan
Dec 4, 2019·Best Practice & Research. Clinical Anaesthesiology·Amit PrabhakarAlan David Kaye
Nov 7, 2019·Revista brasileira de anestesiologia·Layana Vieira NobreLeonardo Henrique Cunha Ferraro
Mar 4, 2021·Expert Opinion on Drug Safety·Zhaosheng JinSergio D Bergese
Jan 13, 2021·Minerva anestesiologica·Stanley Jablonski, Philipp Lirk
Nov 24, 2021·Acta Anaesthesiologica Scandinavica·Jakob H AndersenOle Mathiesen

❮ Previous
Next ❯

Related Concepts

Related Feeds

Bradyarrhythmias

Bradyarrhythmias are slow heart rates. Symptoms may include syncope, dizziness, fatigure, shortness of breath, and chest pains. Find the latest research on bradyarrhythmias here.