Evidence map›Paper›PMID 24671181›Full record

SynthesisPloS one2014

Does dexmedetomidine as a neuraxial adjuvant facilitate better anesthesia and analgesia? A systematic review and meta-analysis.

Huang-Hui Wu, Hong-Tao Wang, Jun-Jie Jin, Guang-Bin Cui, Ke-Cheng Zhou, Yu Chen, Guo-Zhong Chen, Yu-Lin Dong, Wen Wang

2 registry-linked trialsOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 47 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 9 pooled it
11.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02385435 phase2 / phase3completednot on this map

Comparison of Caudal Bupivacaine Alone With Bupivacaine Plus Two Doses of Dexmedetomidine for Postoperative Analgesia in Pediatric Patients Undergoing Infra-umbilical Surgery: A Randomized Controlled Double Blinded Study

TypeinterventionalSponsorUniversity of JordanRan2014 to 2014Enrolled91ConditionsPain, PostoperativeArmsBupivacaine, dexmedetomidine 1μg.kg-1, dexmedetomidine 2μg.kg-1
NCT02630290 phase4completednot on this mapstarted 2015, after this paper: background citation

Addition of Dexmedetomidine to Ropivacaine-induced Supraclavicular Plexus Block, a Randomized Controlled Study

TypeinterventionalSponsorGuangzhou First People's HospitalRan2015 to 2016Enrolled60ConditionsRadius Fractures, Ulna Fractures, Hand Injuries, Wrist InjuriesArmsRopivacaine, Ropivacaine + Dexmedetomidine
3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 9 syntheses or guidelines pooled it, 107 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Huang-Hui WuDepartment of Anesthesiology, Fuzhou General Hospital of Nanjing Military Region, Fuzhou, PR China; Unit for Evidence Based Medicine, Department of Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, Preclinical School of Medicine, Fourth Military Medical University, Xi'an, PR China.
Hong-Tao WangUnit for Evidence Based Medicine, Department of Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, Preclinical School of Medicine, Fourth Military Medical University, Xi'an, PR China; Department of Burn and Cutaneous Surgery, Xi'jing Hospital, Fourth Military Medical University, Xi'an, PR China.
Jun-Jie JinUnit for Evidence Based Medicine, Department of Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, Preclinical School of Medicine, Fourth Military Medical University, Xi'an, PR China; Department of Neurosurgery, Fuzhou General Hospital of Nanjing Military Region, Fuzhou, PR China.
Guang-Bin CuiUnit for Evidence Based Medicine, Department of Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, Preclinical School of Medicine, Fourth Military Medical University, Xi'an, PR China; Department of Diagnostic Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, PR China.
Ke-Cheng ZhouUnit for Evidence Based Medicine, Department of Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, Preclinical School of Medicine, Fourth Military Medical University, Xi'an, PR China; China Pharmaceutical University, Nanjing, PR China.
Yu ChenDepartment of Anesthesiology, Fuzhou General Hospital of Nanjing Military Region, Fuzhou, PR China.
Guo-Zhong ChenDepartment of Anesthesiology, Fuzhou General Hospital of Nanjing Military Region, Fuzhou, PR China.
Yu-Lin DongUnit for Evidence Based Medicine, Department of Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, Preclinical School of Medicine, Fourth Military Medical University, Xi'an, PR China.
Wen WangUnit for Evidence Based Medicine, Department of Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, Preclinical School of Medicine, Fourth Military Medical University, Xi'an, PR China.
Air Force Medical University · CNFuzhou General Hospital of Nanjing Military Command · CNChina Pharmaceutical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeuraxial application of dexmedetomidine (DEX) as adjuvant analgesic has been invetigated in some randomized controlled trials (RCTs) but not been approved because of the inconsistency of efficacy and safety in these RCTs. We performed this meta-analysis to access the efficacy and safety of neuraxial DEX as local anaesthetic (LA) adjuvant.

methodsWe searched PubMed, PsycINFO, Scopus, EMBASE, and CENTRAL databases from inception to June 2013 for RCTs that investigated the analgesia efficacy and safety for neuraxial application DEX as LA adjuvant. Effects were summarized using standardized mean differences (SMDs), weighed mean differences (WMDs) or odds ratio (OR) with suitable effect model. The primary outcomes were postoperative pain intensity and analgesic duration, bradycardia and hypotension.

resultsSixteen RCTs involving 1092 participants were included. Neuraxial DEX significantly decreased postoperative pain intensity (SMD, -1.29; 95% confidence interval (CI), -1.70 to -0.89; P<0.00001), prolonged analgesic duration (WMD, 6.93 hours; 95% CI, 5.23 to 8.62; P<0.00001) and increased the risk of bradycardia (OR, 2.68; 95% CI, 1.18 to 6.10; P = 0.02). No evidence showed that neuraxial DEX increased the risk of other adverse events, such as hypotension (OR, 1.54; 95% CI, 0.83 to 2.85; P = 0.17). Additionally, neuraxial DEX was associated with beneficial alterations in postoperative sedation scores and number of analgesic requirements, sensory and motor block characteristics, and intro-operative hemodynamics.

conclusionNeuraxial DEX is a favorable LA adjuvant with better and longer analgesia. The greatest concern is bradycardia. Further large sample trials with strict design and focusing on long-term outcomes are needed.

Indexed as

AnalgesiaAnalgesics, Non-NarcoticAnesthesiaAnesthetics, LocalBradycardiaChemotherapy, AdjuvantDexmedetomidineHumansHypotensionPain ManagementPostoperative PainRandomized Controlled Trials as TopicAnalgesics, Non-NarcoticAnesthetics, LocalDexmedetomidine

Identifiers

PMID24671181
PMCPMC3966844
OpenAlexW2031230966

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.