Dexmedetomidine as an adjuvant to local anesthetics in brachial plexus blocks: A meta-analysis of randomized controlled trials

• Published in: Medicine (Baltimore) 2017-01, Vol.96 (4), p.e5846-e5846
• Main Authors: Ping, Yongmei, Ye, Qigang, Wang, Wenwei, Ye, Pingke, You, Zhibin
• Format: Article
• Language: English
• Subjects: Adjuvants, Anesthesia - administration & dosage; Adult; Analgesics, Non-Narcotic - administration & dosage; Anesthetics, Local - administration & dosage; Brachial Plexus Block - methods; Dexmedetomidine - administration & dosage; Female; Humans; Male; Middle Aged; Randomized Controlled Trials as Topic; Systematic Review and Meta-Analysis; Treatment Outcome; Upper Extremity - surgery
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000005846

Brachial plexus block (BPB) for upper extremity surgery provides superior analgesia, but this advantage is limited by the pharmacological duration of local anesthetics. Dexmedetomidine (DEX) as a local anesthetics adjuvant for BPB has been utilized to prolong the duration of the nerve block in some randomized controlled trials (RCTs) but is far from unanimous in the efficacy and safety of the perineural route. Hence, an updated meta-analysis was conducted to assess the efficacy and safety of DEX as local anesthetic adjuvants on BPB. A search in electronic databases was conducted to collect the RCTs that investigated the impact of adding DEX to local anesthetics for BPB. Sensory block duration, motor block duration, onset time of sensory and motor block, time to first analgesic request, the common adverse effects were analyzed. Eighteen trails (1014 patients) were included with 515 patients receiving perineural DEX. The addition of DEX prolonged the duration of sensory block (WMD 257 minutes, 95%CI 191.79-322.24, P