ReviewCureus2026
Clinical Application and Safety of Intrathecal Adjuvants in Single-Shot Thoracic Segmental Spinal Anesthesia: A Narrative Review.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Thoracic segmental spinal anesthesia (TSSA) is an emerging regional anesthesia (RA) technique. TSSA with local anesthetic (LA) alone is associated with a relatively short duration of surgical anesthesia and postoperative analgesia, which may limit its clinical utility. Intrathecal adjuvants have been widely used in lumbar spinal anesthesia (LSA) to prolong block duration and improve block quality. However, their role in TSSA remains poorly defined. This review summarizes commonly used intrathecal adjuvants during TSSA, their doses, adverse effects, and safety considerations. A comprehensive literature search was performed using PubMed, Europe PubMed Central (PMC), and Google Scholar. Key search terms included "thoracic spinal anesthesia," "thoracic segmental spinal anesthesia," "segmental thoracic spinal anesthesia," "intrathecal adjuvant," "fentanyl," "dexmedetomidine," and "clonidine." A total of 463 relevant articles were identified from PubMed (39), Europe PMC (26), and Google Scholar (398). Finally, 76 articles were selected for the review. An important observation from this review is the growing role of adjuvants in TSSA. Common intrathecal adjuvants in TSSA include opioids and α2-agonists and, less commonly, benzodiazepines, corticosteroids, and N-methyl-D-aspartate (NMDA) antagonists. Several studies reported satisfactory surgical conditions with the preservation of spontaneous ventilation and improved hemodynamic stability. This finding has important implications for high-risk patients with severe cardiopulmonary diseases. Intrathecal adjuvants significantly improve block quality, prolong analgesia, and reduce local anesthetic requirements. Fentanyl and dexmedetomidine are the most extensively studied adjuvants in TSSA; morphine, buprenorphine, and ketamine have also been evaluated in a smaller number of studies and appear clinically useful. However, adverse effects such as hypotension, bradycardia, respiratory depression, and opioid-related complications remain important concerns.
Indexed as
Identifiers
What OpenQuestion holds
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.