Department of Anesthesiology, Affiliated Hospital of Jiaxing University, The First Hospital of Jiaxing, Jiaxing, Zhejiang, China.
Department of Gynecology, Tongxiang Maternal and Child Health Care Hospital, Tongxiang, Zhejiang, China.
J Int Med Res. 2020 May;48(5):300060520913423. doi: 10.1177/0300060520913423.
Previous studies reported the effect of dexmedetomidine on intrathecal anesthesia. In this review, we explored the impact of dexmedetomidine as an adjunct for lumbar anesthesia in patients undergoing cesarean section.
Two authors searched eligible random controlled trials in electronic databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, the Chinese BioMedical database, Chinese Scientific Journal Database, and the Wanfang database.
Ten trials comprising 970 patients were included in this review. Intrathecal dexmedetomidine significantly reduced the onset time of sensory block (standardized mean difference (SMD), -1.50, 95% confidence interval (CI) -2.15, -0.85, = 92%) and motor block (SMD -0.77, 95% CI -1.50, -0.49, = 60%) and prolonged the block duration time (sensory block: SMD 2.02, 95% CI 1.29, 2.74, = 93%; motor block: SMD 1.90, 95% CI 1.07, 2.74, = 94%). Patients who received dexmedetomidine showed a lower incidence of shivering. No significant difference was reported for the neonatal Apgar score and other complications.
The use of intrathecal dexmedetomidine during cesarean section can shorten the onset time of spinal anesthesia and enhance the effect of local anesthetic. It has no significant impact on neonates and there were no other adverse events.
先前的研究报告了右美托咪定对鞘内麻醉的影响。在本综述中，我们探讨了右美托咪定作为剖宫产患者腰麻辅助用药的影响。
两位作者在电子数据库（包括 PubMed、Embase、Cochrane 图书馆、Web of Science、中国知网、中国生物医学文献数据库、中国科学引文数据库和万方数据库）中搜索了符合条件的随机对照试验。
本综述纳入了 10 项试验，共 970 名患者。鞘内给予右美托咪定可显著缩短感觉阻滞（均数差（SMD）-1.50，95%置信区间（CI）-2.15 至-0.85， = 92%）和运动阻滞（SMD-0.77，95%CI-1.50 至-0.49， = 60%）的起效时间，并延长阻滞持续时间（感觉阻滞：SMD 2.02，95%CI 1.29 至 2.74， = 93%；运动阻滞：SMD 1.90，95%CI 1.07 至 2.74， = 94%）。接受右美托咪定的患者寒战发生率较低。新生儿 Apgar 评分和其他并发症无显著差异。
剖宫产术中鞘内应用右美托咪定可缩短脊麻起效时间，增强局部麻醉效果。对新生儿无显著影响，无其他不良事件。
