Block Quality Of Dexmedetomidine-Based Spinal Anaesthesia In Orthopaedic Surgeries: A Meta-Analysis Of Clinical Trials

  • Abdulrahman Ahmad Alhajahjeh Faculty of Medicine , University of Jordan
  • Aiman Suleiman Center for Anesthesia Research Excellence, Harvard Medical School, Beth Israel Deaconess Medical Center, Department of Anesthesia and Intensive Care, Boston, MA, United states
  • Hamza M Almustafa faculty of medicine , the university of Jordan
  • Tala M Mesmar faculty of medicine , university of Jordan
  • Anas Hamdan Istishari hospital , Jordan
  • Mahmoud M Almustafa Faculty of Medicine, Department of Anesthesia and Intensive care, The University of Jordan, P.O. BOX 13046, Amman, Jordan
DOI: https://doi.org/10.35975/apic.v27i1.1876
Keywords: Dexmedetomidine, Spinal Anesthesia, Orthopedic surgery, Meta-analysis.

Abstract

Background: Dexmedetomidine is used as an adjuvant to local anesthetic agents in spinal anesthesia and is believed to increase quality of sensory and motor blocks. Our aim was to assess the effects of dexmedetomidine as an adjunct on block quality of spinal anesthesia in orthopedic procedures.

Methodology: A systematic review of randomized control trials was conducted to assess the effect of intrathecal dexmedetomidine added to local anesthetic agents on the block quality of spinal anesthesia in orthopedic surgeries. PubMed, Google scholar, and Medline databases were searched for randomized controlled clinical trials. Studies met our inclusion criteria, if they used intrathecal 5 µg dexmedetomidine as an additive to 2.5−3 ml (12.5−15 mg) bupivacaine or ropivacaine, and these were included in our meta-analysis.

Results: Eight trials comprising 510 patients matched our inclusion criteria. Time to one sensory segment block regression (mean difference 139.72 min; 95% confidence interval (CI) 35.18−244.26; P = 0.009), two sensory segments block regression (mean difference 54.8 min; 95% CI [31.36−78.24]; P < 0.001), and Bromage score of zero (mean difference 93.66 min; 95%CI [30.20−157.12]; P = 0.004 ) were significantly prolonged in dexmedetomidine group. There were no significant differences between dexmedetomidine group and control group in duration of surgery (P = 0.33) or time till block reaches T10 dermatomal level (P = 0.30). Finally, time to reach Bromage score of III following injection was significantly shorter in dexmedetomidine group (mean difference 2.62 min; 95%CI [−5.12−−0.13]; P = 0.04).

Conclusion: Dexmedetomidine was found to achieve extended motor and sensory block when needed, bearing in mind higher cost and potential side effects.

Key words: Dexmedetomidine, Spinal Anesthesia, Orthopedic surgery, Meta-analysis.

Citation: Alhajahjeh AA, Suleiman A, Almustafa HM, Mesmar TM, Hamdan A, Almustafa MM. Neuraxial block quality of dexmedetomidine-containing regimens in orthopedic surgeries: a meta-analysis. Anaesth. pain intensive care 2022;27(1):43−52.

DOI: 10.35975/apic.v27i1.1876

Received: May 22, 2022; Reviewed: August 14, 2022; Accepted: December 28, 2022

Author Biographies

Abdulrahman Ahmad Alhajahjeh, Faculty of Medicine , University of Jordan

Faculty of Medicine, The University of Jordan, The University of Jordan, P.O. BOX 13046, Amman, Jordan

Aiman Suleiman, Center for Anesthesia Research Excellence, Harvard Medical School, Beth Israel Deaconess Medical Center, Department of Anesthesia and Intensive Care, Boston, MA, United states

Center for Anesthesia Research Excellence, Harvard Medical School, Beth Israel Deaconess Medical Center, Department of Anesthesia and Intensive Care, Boston, MA, United states

Hamza M Almustafa, faculty of medicine , the university of Jordan

Faculty of Medicine, The University of Jordan, The University of Jordan, P.O. BOX 13046, Amman, Jordan

Tala M Mesmar, faculty of medicine , university of Jordan

Faculty of Medicine, The University of Jordan, The University of Jordan, P.O. BOX 13046, Amman, Jordan

Anas Hamdan, Istishari hospital , Jordan

Anesthesia specialist, Istishari Hospital, Department of Anesthesia, Amman, Jordan

Mahmoud M Almustafa, Faculty of Medicine, Department of Anesthesia and Intensive care, The University of Jordan, P.O. BOX 13046, Amman, Jordan

Faculty of Medicine, Department of Anesthesia and Intensive care, The University of Jordan, P.O. BOX 13046, Amman, Jordan

Published
03-02-2023
How to Cite
Alhajahjeh, A., Suleiman, A., Almustafa, H., Mesmar, T., Hamdan, A., & Almustafa, M. (2023). Block Quality Of Dexmedetomidine-Based Spinal Anaesthesia In Orthopaedic Surgeries: A Meta-Analysis Of Clinical Trials. Anaesthesia, Pain & Intensive Care, 27(1), 43-52. https://doi.org/10.35975/apic.v27i1.1876
Issue
Vol 27 No 1 (2023): February 2023
Section
Review Article