کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
8929882 1644508 2018 13 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
The impact of neuraxial clonidine on postoperative analgesia and perioperative adverse effects in women having elective Caesarean section-a systematic review and meta-analysis
ترجمه فارسی عنوان
تأثیر کلونیدین نوراکسایس بر درد پس از عمل جراحی و اثرات جانبی آن در زنان مبتلا به سزارین انتخابی - یک بررسی سیستماتیک و متاآنالیز
کلمات کلیدی
آگونیست گیرنده آلفا 2 آدرنرژیک، بخش سزارین، کلونیدین،
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیهوشی و پزشکی درد
چکیده انگلیسی
Neuraxial clonidine improves postoperative analgesia in the general surgical population. The efficacy and safety of neuraxial clonidine as a postoperative analgesic adjunct in the Caesarean section population still remains unclear. This systematic review and meta-analysis aims to evaluate the effect of perioperative neuraxial clonidine on postoperative analgesia in women having Caesarean section under neuraxial anaesthesia. We included randomized controlled trials comparing the analgesic efficacy of the perioperative administration of neuraxial clonidine alone or in combination with a local anaesthetic and/or opioids in women having elective Caesarean section under neuraxial anaesthesia when compared with placebo. PubMed, the Cochrane Central Register of Controlled Trials, and EMBASE were searched until February 2017. Eighteen studies were included in the meta-analysis. Neuraxial clonidine reduced 24 h morphine consumption [mean difference (MD): −7.2 mg; 95% confidence interval (CI): −11.4, −3.0 mg; seven studies] and prolonged time to first analgesic request (MD: 135 min; 95% CI: 102, 168 min; 16 studies) when compared with the control group. Neuraxial clonidine increased intraoperative hypotension [odds ratio (OR): 2.849; 95% CI: 1.363, 5.957], intraoperative sedation (OR: 2.355; 95% CI: 1.016, 5.459), but reduced the need for intraoperative analgesic supplementation (OR: 0.224; 95% CI: 0.076, 0.663). The effect of clonidine on intraoperative bradycardia, intraoperative and postoperative nausea and vomiting, postoperative sedation, and pruritus were inconclusive. Neuraxial clonidine did not negatively impact neonatal umbilical artery pH or Apgar scores. This review demonstrates that neuraxial clonidine enhances postoperative analgesia in women having Caesarean section with neuraxial anaesthesia, but this has to be balanced against increased maternal adverse effects.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: British Journal of Anaesthesia - Volume 120, Issue 2, February 2018, Pages 228-240
نویسندگان
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