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Dexmedetomidine as a neuraxial adjuvant for prevention of perioperative shivering: Meta-analysis of randomized controlled trials

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机构： [1]Department of Anesthesiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China, [2]Department of Anesthesiology, Ji Shui Tan Hospital and Fourth Medical College of Peking University, Beijing, China, [3]Department of Anesthesiology, Beijing Xuanwu Hospital of Capital Medical University, Beijing, China

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Background Dexmedetomidine, a highly selective alpha 2-adrenoceptor agonist, has been investigated for anti-shivering effects in some trials. This current meta-analysis was conducted to evaluate the effectiveness of dexmedetomidine as a neuraxial adjuvant in preventing perioperative shivering. Methods This systematic review and meta-analysis was registered in PROSPERO [www.crd.york.ac. uk/PROSPERO] with the unique identification number CRD42017055991. The electronic databases PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) were searched to select high-quality randomized controlled trials (RCTs) that evaluated the anti-shivering efficacy for neuraxial application dexmedetomidine as local anesthetic adjuvant. Effects were summarized using pooled risk ratios (RRs), weighed mean differences (MDs), or standardized mean differences (SMDs) and corresponding 95% confidence intervals (Cls) with random effect model. Heterogeneity assessment, sensitivity analysis, and publication bias were performed. The primary outcome was perioperative shivering. Results A total of 1760 patients from 24 studies were included in this meta-analysis. Compared with the placebo, dexmedetomidine reduced the incidence of perioperative shivering (RR: 0.34; 95% Cl: 0.21 to 0.55; P < 0.00001), with a maximum effective dose of 5 mu g via subarachnoid space injection (RR: 0.55; 95% CI: 0.32 to 0.92; P = 0.02), especially in cesarean section (RR: 0.20; 95% CI: 0.09 to 0.45; P = 0.0001). Dexmedetomidine also could improve the characteristics of the block, with an increase only in the incidence of bradycardia (RR: 2.11; 95% CI: 1.23 to 3.60; P = 0.006). No significant difference could be found compared dexmedetomidine with other adjuvants, except morphine. Conclusions This meta-analysis shows that dexmedetomidine as a neuraxial adjuvant had statistically significant efficacy on prevention of perioperative shivering. Moreover, dexmedetomidine could improve the characteristics of the block. However, the potential induction of bradycardia should be taken seriously.

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出版当年[2016]版：

大类 | 3 区生物

小类 | 3 区综合性期刊

最新[2023]版：

大类 | 3 区综合性期刊

小类 | 3 区综合性期刊

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出版当年[2015]版：

Q1 MULTIDISCIPLINARY SCIENCES

最新[2023]版：

Q1 MULTIDISCIPLINARY SCIENCES

影响因子： 2.9 最新[2023版] 3.3 最新五年平均 3.057 出版当年[2015版] 3.535 出版当年五年平均 3.234 出版前一年[2014版] 2.806 出版后一年[2016版]

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第一作者机构： [1]Department of Anesthesiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China,

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通讯机构： [1]Department of Anesthesiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China,

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