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29 January 2020 : Meta-Analysis  

Fetal and Maternal Responses to Dexmedetomidine Intrathecal Application During Cesarean Section: A Meta-Analysis

ShuJun Sun1ADE, JiaMei Wang2BC, JingXu Wang1B, FuQuan Wang1C, HaiFa Xia1AB*, ShangLong Yao1A

DOI: 10.12659/MSM.918523

Med Sci Monit 2020; 26:e918523


BACKGROUND: Intrathecal dexmedetomidine (DEX) can improve the blockade of spinal anesthesia, but there is no clear conclusion on whether it has an effect on the fetus during cesarean section. Our meta-analysis evaluated the safety and efficacy of intrathecal DEX in cesarean delivery.

MATERIAL AND METHODS: We searched Cochrane, Embase, PubMed, and CBM for eligible studies, and used the Revised Cochrane Risk of Bias Tool (RoB 2.0) to assess the risk of bias of each study. RevMan was used for statistical analyses. We have registered this meta-analysis on PROSPERO (CRD42019120995).

RESULTS: The meta-analysis included 10 RCTs, but only 5 were prospectively registered. The results of preregistration studies, including the 1- or 5-min Apgar score (mean difference [MD], –0.03; 95% confidence intervals [CI], –0.16 to 0.10; P=0.64 or MD, 0.00; 95% CI, –0.09 to 0.09; P=1), the umbilical arterial oxygen or carbon dioxide partial pressure (MD, 0.90; 95% CI, –4.92 to 6.72; P=0.76 or MD, 1.20; 95% CI, –2.06 to 4.46; P=0.47), and the cord blood pH (MD, –0.01; 95% CI, –0.05 to 0.03; P=0.72), showed that intrathecal DEX had no significant difference in neonatal outcomes compared with placebo. In maternal outcomes, intrathecal DEX significantly prolonged postoperative pain-free period and reduced the incidence of postoperative shivering, which did not increase spinal anesthesia-associated adverse effects.

CONCLUSIONS: Intrathecal DEX is safe for the fetus during cesarean section and can improve the blockade effects of spinal anesthesia on puerperae.

Keywords: Adjuvants, Anesthesia, Anesthesia, Spinal, Dexmedetomidine, Fetus, meta-analysis, Randomized controlled trial, Apgar Score, Cesarean Section, Infant, Newborn, Postoperative Period, Pregnancy, Pregnancy Outcome, Publication Bias, Risk, Shivering, visual analog scale



01 January 2023 : Editorial  

Editorial: Current Status of Two Adjuvanted Malaria Vaccines and the World Health Organization (WHO) Strategy to Eradicate Malaria by 2030

Dinah V. Parums
Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA

DOI: 10.12659/MSM.939357

Med Sci Monit 2023; 29:e939357


26 January 2023 : Editorial  

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Med Sci Monit In Press; DOI: 10.12659/MSM.939580  

19 January 2023 : Clinical Research  

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26 Jan 2023 : Editorial  

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750