Evidence map›Paper›PMID 36644042›Full record

ReviewCureus2022

A Systematic Review and Meta-analysis of Efficacy and Safety of Dexmedetomidine Combined With Intrathecal Bupivacaine Compared to Placebo.

Subodh Kumar, Biswadeep Choudhury, Seshadri R Varikasuvu, Harminder Singh, Sanjay Kumar, Joonmoni Lahon, Dibyajyoti Saikia

Registry-linked trialOpen access · diamondAbstract readReview
In one paragraph

Review in Cureus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07078201 (Comparative Analysis of Intraoperative Effect Dexmedetomidine and Fentanyl as an Adjuvant to Heavy Bupivacaine in Spinal Anaesthesia in Lower Limb Orthopedic Surgeries.), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.8field-weighted citation impact, top 9% 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.

NCT07078201 phase4recruitingnot on this mapstarted 2025, after this paper: background citation

Comparative Analysis of Intraoperative Effect Dexmedetomidine and Fentanyl as an Adjuvant to Heavy Bupivacaine in Spinal Anaesthesia in Lower Limb Orthopedic Surgeries.

TypeinterventionalSponsorNashwa AhmedRan2025 to 2025Enrolled40ConditionsSpinal Anesthesia DurationArmsDexmedetomidine, fentanyl
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 11 citations in OpenAlex.

  1. Review
  2. Adjuvant Analgesics in Acute Pain - Evaluation of Efficacy.Current pain and headache reports · 2024
    Review
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

7 authors at 3 institutions in 2 countries.

Subodh KumarPharmacology, AIIMS Deoghar, Deoghar, IND.
Biswadeep ChoudhuryAnaesthesiology, Guwahati Medical College and Hospital, Guwahati, IND.
Seshadri R VarikasuvuBiochemistry, AIIMS Deoghar, Deoghar, IND.
Harminder SinghPharmacology, AIIMS Deoghar, Deoghar, IND.
Sanjay KumarAnaesthesiology, AIIMS Deoghar, Deoghar, IND.
Joonmoni LahonPharmacology, AIIMS Guwahati, Guwahati, IND.
Dibyajyoti SaikiaPharmacology, AIIMS Guwahati, Guwahati, IND.
Indian Institute of Technology Guwahati · INWockhardt (United States) · USAll India Institute of Medical Sciences Guwahati

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDexmedetomidine has been approved as a sedative agent in critical patients. It is also frequently used as an adjuvant with local anesthetic in spinal anesthesia. However, its use as an adjuvant has not been approved due to the paucity of data. The present systematic review and meta-analysis were undertaken to synthesize evidence for efficacy and safety when dexmedetomidine is combined with bupivacaine in spinal anesthesia.

methodsA literature search was done using PubMed, Google Scholar, Embase, and Cochrane Library. Search results were screened and eligible studies were included to perform a systematic review and meta-analysis using the software 'Review Manager (RevMan) version 5.4.1' using a random effect model. Cochrane's' Risk of Bias tool (RoB2)' was used for quality assessment. Mean and standard deviation was used to calculate the standardized mean difference and its forest plot for efficacy measures. For the adverse event, a number of events were used to determine the risk ratio and its forest plot using RevMan software. Publication bias is visualized using a funnel plot.

resultsA total of 21 randomized control trials evaluating the efficacy and safety of intrathecal dexmedetomidine were included in the meta-analysis. A total of 1382 participants was included in this meta-analysis. The effect estimates for efficacy parameters, i.e. duration of the sensory block having SMD 2.33; CI, 1.83-2.83, motor block with SMD 1.83, CI 1.21, 2.46, and analgesia SMD 2.81; CI, 2.11-3.51. The risk ratio for adverse effects, i.e. nausea/vomiting, bradycardia, hypotension was not significant whereas it was significant for the incidence of shivering with RR 0.38; CI 0.23-0.97. The overall risk of bias among included studies was either of 'some concern' or 'high risk.'

conclusionsIntrathecal dexmedetomidine when combined with bupivacaine was found to significantly increase the three efficacy parameters, i.e. duration of sensory block, motor block, and analgesia. It also appears to be safe with no increased risk of bradycardia or hypotension. It is also associated with decreased postoperative shivering.

Indexed as

analgesiadexmedetomidinesensory blockshiveringspinal anesthesia

Identifiers

PMID36644042
PMCPMC9832396
OpenAlexW4311153722

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.