SynthesisBMC anesthesiology2025
Efficacy and safety of midazolam compared to fentanyl as adjuvants to hyperbaric bupivacaine in spinal anesthesia: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
7 authors.
Funding
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Abstract
backgroundVarious drugs have been used as adjuvants to local anesthetics to prolong analgesia and reduce the dosage and side effects of local anesthetics in regional anesthesia and peripheral nerve blocks.
methodsThe literature search was conducted using Google Scholar, PubMed, and the Cochrane Library for randomized controlled trials comparing fentanyl or midazolam to bupivacaine in spinal anesthesia. Studies that reported any of the primary outcomes, duration of sensory block, analgesia and motor block were included. Safety parameters and postoperative pain were the secondary outcomes. The risk of bias and publication bias were assessed using the Cochrane risk of bias tool and Egger's test respectively. A p-value less than 0.05 at 95% confidence interval indicated statistical significance.
resultsThis meta-analysis included 12 RCT studies (n = 812). Seven studies (n = 498) reported duration of sensory block and found no significant difference between the groups (MD = 12.18 min; 95% CI- 9.97, 34.34; I
conclusionFentanyl or midazolam added to bupivacaine show comparable sensory block durations. Midazolam prolongs motor block and analgesia in obstetric surgeries, while fentanyl extends analgesia in non-obstetric cases. Both show similar risks of hypotension, bradycardia, and respiratory depression, but fentanyl increases nausea, vomiting, shivering, and pruritus. There is no difference in postoperative pain scores. The findings need cautious interpretation due to considerable heterogeneity in the duration of sensory block, analgesia, and motor block, and unclear risk of bias. The low heterogeneity in safety outcomes supports a consistent safety profile.
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