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Effect of intrathecal dexmedetomidine on preventing shivering in cesarean section after spinal anesthesia: a meta-analysis and trial sequential analysis.
Drug Des Devel Ther. 2018; 12:3775-3783.DD

Abstract

Objective

Intrathecal dexmedetomidine (DEX) has been used to prevent shivering in patients undergoing cesarean section. The aim of this meta-analysis was to evaluate whether intrathecal DEX could prevent shivering in cesarean section after spinal anesthesia.

Methods

We searched PubMed, Embase, Web of Science, and the Cochrane Library for randomized controlled trials (RCTs) comparing intrathecal DEX in cesarean section after spinal anesthesia with placebo and reporting on shivering, postoperative nausea and vomiting (PONV), hypotension, and bradycardia. Trial sequential analysis (TSA) was also carried out for RCTs comparing DEX with placebo. This meta-analysis has been registered on PROSPERO, and the registration number is CRD42017071640.

Results

Six randomized clinical trials comparing 360 patients were included in this study. Compared with placebo, intrathecal DEX significantly reduced the incidence of shivering (risk ratio [RR]=0.40; 95% CI [0.26, 0.62]; P<0.0001). No significant difference was found in the incidence of PONV (RR=1.34; 95% CI [0.82, 2.18]; P=0.24), hypotension (RR=1.09; 95% CI [0.84, 1.42]; P=0.50), or bradycardia (RR=1.55; 95% CI [0.54, 4.42]; P=0.42). However, no firm conclusions can be made based on the results of all outcomes according to the TSA.

Conclusion

This meta-analysis found that intrathecal DEX could prevent shivering in cesarean section after spinal anesthesia and did not induce PONV, hypotension, or bradycardia. However, firm conclusions cannot be made until more studies are conducted.

Authors+Show Affiliations

Department of Anesthesiology, The Affiliated Hospital of XuZhou Medical University, XuZhou, JiangSu, China, wguanglei2000@163.com.Department of Anesthesiology, The Affiliated Hospital of XuZhou Medical University, XuZhou, JiangSu, China, wguanglei2000@163.com.Department of Anesthesiology, The Affiliated Hospital of XuZhou Medical University, XuZhou, JiangSu, China, wguanglei2000@163.com.Department of Anesthesiology, The Affiliated Hospital of XuZhou Medical University, XuZhou, JiangSu, China, wguanglei2000@163.com.

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

30464408

Citation

Miao, Shuai, et al. "Effect of Intrathecal Dexmedetomidine On Preventing Shivering in Cesarean Section After Spinal Anesthesia: a Meta-analysis and Trial Sequential Analysis." Drug Design, Development and Therapy, vol. 12, 2018, pp. 3775-3783.
Miao S, Shi M, Zou L, et al. Effect of intrathecal dexmedetomidine on preventing shivering in cesarean section after spinal anesthesia: a meta-analysis and trial sequential analysis. Drug Des Devel Ther. 2018;12:3775-3783.
Miao, S., Shi, M., Zou, L., & Wang, G. (2018). Effect of intrathecal dexmedetomidine on preventing shivering in cesarean section after spinal anesthesia: a meta-analysis and trial sequential analysis. Drug Design, Development and Therapy, 12, 3775-3783. https://doi.org/10.2147/DDDT.S178665
Miao S, et al. Effect of Intrathecal Dexmedetomidine On Preventing Shivering in Cesarean Section After Spinal Anesthesia: a Meta-analysis and Trial Sequential Analysis. Drug Des Devel Ther. 2018;12:3775-3783. PubMed PMID: 30464408.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of intrathecal dexmedetomidine on preventing shivering in cesarean section after spinal anesthesia: a meta-analysis and trial sequential analysis. AU - Miao,Shuai, AU - Shi,Mengzhu, AU - Zou,Lan, AU - Wang,Guanglei, Y1 - 2018/11/02/ PY - 2018/11/23/entrez PY - 2018/11/23/pubmed PY - 2019/3/27/medline KW - adverse effect KW - cesarean section KW - dexmedetomidine KW - meta-analysis KW - spinal anesthesia KW - trial sequential analysis SP - 3775 EP - 3783 JF - Drug design, development and therapy JO - Drug Des Devel Ther VL - 12 N2 - Objective: Intrathecal dexmedetomidine (DEX) has been used to prevent shivering in patients undergoing cesarean section. The aim of this meta-analysis was to evaluate whether intrathecal DEX could prevent shivering in cesarean section after spinal anesthesia. Methods: We searched PubMed, Embase, Web of Science, and the Cochrane Library for randomized controlled trials (RCTs) comparing intrathecal DEX in cesarean section after spinal anesthesia with placebo and reporting on shivering, postoperative nausea and vomiting (PONV), hypotension, and bradycardia. Trial sequential analysis (TSA) was also carried out for RCTs comparing DEX with placebo. This meta-analysis has been registered on PROSPERO, and the registration number is CRD42017071640. Results: Six randomized clinical trials comparing 360 patients were included in this study. Compared with placebo, intrathecal DEX significantly reduced the incidence of shivering (risk ratio [RR]=0.40; 95% CI [0.26, 0.62]; P<0.0001). No significant difference was found in the incidence of PONV (RR=1.34; 95% CI [0.82, 2.18]; P=0.24), hypotension (RR=1.09; 95% CI [0.84, 1.42]; P=0.50), or bradycardia (RR=1.55; 95% CI [0.54, 4.42]; P=0.42). However, no firm conclusions can be made based on the results of all outcomes according to the TSA. Conclusion: This meta-analysis found that intrathecal DEX could prevent shivering in cesarean section after spinal anesthesia and did not induce PONV, hypotension, or bradycardia. However, firm conclusions cannot be made until more studies are conducted. SN - 1177-8881 UR - https://www.unboundmedicine.com/medline/citation/30464408/Effect_of_intrathecal_dexmedetomidine_on_preventing_shivering_in_cesarean_section_after_spinal_anesthesia:_a_meta_analysis_and_trial_sequential_analysis_ L2 - https://dx.doi.org/10.2147/DDDT.S178665 DB - PRIME DP - Unbound Medicine ER -