Background: To evaluate the efficacy of dexmedetomidine versus clonidine as adjuvants to local anesthetics in spinal anesthesia. Methods: We searched PubMed, Embase, Web of Science, and the Cochrane Library databases for randomized controlled trials (RCTs) comparing the effects of dexmedetomidine and clonidine when used as adjuvants to intrathecal local anesthetics. Results: A total of 10 randomized controlled trials were included in this meta-analysis. Compared with clonidine, dexmedetomidine significantly improved spinal block characteristics, including a faster onset of sensory block (standardized mean difference: −0.57, 95% confidence interval CI: −1.06 to −0.090; P < .05), a longer duration of sensory block (mean difference MD = 29.87 minutes, 95% CI: 21.89–37.86; P < .05), a longer duration of motor block (MD = 31.12 minutes, 95% CI: 14.51–47.73; P < .05), and a prolonged time to first rescue analgesia (MD = 21.86 minutes, 95% CI: 13.14–30.59; P < .05). No statistically significant differences were observed between the clonidine and dexmedetomidine groups with respect to the incidence of nausea and vomiting, bradycardia, hypotension, or shivering ( P ≥ .05). Conclusion: When used as an intrathecal adjuvant and compared with clonidine, dexmedetomidine yields superior spinal block characteristics, including a shorter onset time of sensory block, longer durations of both sensory and motor block, and an extended time to first rescue analgesia. No differences were detected between the 2 drugs in the incidence of nausea and vomiting, bradycardia, hypotension, and shivering.
Yang et al. (Fri,) studied this question.
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