| Title |
Clonidine versus other adjuncts added to local anesthetics for pediatric neuraxial blocks: a systematic review and meta-analysis
|
|---|---|
| Published in |
Journal of Pain Research, May 2018
|
| DOI | 10.2147/jpr.s158264 |
| Pubmed ID | |
| Authors |
Yang Yang, Ling-Yu Yu, Wen-Sheng Zhang |
| Abstract |
Clonidine is a common adjunct to local anesthetics for pediatric neuraxial block; however, the pros and cons between clonidine and other adjuncts remain unclear. Thus, we performed this meta-analysis of randomized controlled trials to assess the efficacy and adverse effects between clonidine and other adjuncts added to local anesthetics. The systematic search, data extraction, critical appraisal, and pooled analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Randomized controlled studies were searched in Cochrane (to present), Medline (1946 to present), Embase (1974 to present), and Biosis (1995 to present). Relative risks (RRs), standard mean difference (SMD), and associated CIs were calculated using RevMan statistical software to assess continuous and dichotomous data. Heterogeneity in studies was measured by forest plots and I2 values. Subgroup analysis was performed for continuous and dichotomous variables, while meta-regression was applied for continuous data with high I2 values. A total of 15 randomized controlled studies met the inclusion criteria. There was a longer duration of postoperative analgesia in the clonidine group than for other adjuncts (SMD=1.54, p=0.005, I2=96%). The number of patients requiring rescue analgesia was lower in the clonidine group without the addition of epinephrine (RR=0.55, p=0.0002, I2=0), while the RR for the comparison with epinephrine was significant (p=0.62, I2=95%). The duration of motor block was longer in the clonidine group (mean difference [MD]=1.06, p<0.00001, I2=0). The clonidine group also had a lower incidence of postoperative nausea and vomiting (PONV; RR=0.49, p<0.00001, I2=0). Postoperative bradycardia, hypotension, and urinary retention were not significantly different between clonidine and other adjuncts (p>0.05). Clonidine, compared with other adjuncts, added to local anesthetics for neuraxial block, provides a longer duration of postoperative analgesia with lower incidence of PONV. However, the duration of motor block may also be prolonged by clonidine. |
X Demographics
The data shown below were collected from the profiles of 12 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | 25% |
| Venezuela, Bolivarian Republic of | 2 | 17% |
| United Kingdom | 1 | 8% |
| Netherlands | 1 | 8% |
| United Arab Emirates | 1 | 8% |
| Canada | 1 | 8% |
| Unknown | 3 | 25% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 8 | 67% |
| Practitioners (doctors, other healthcare professionals) | 3 | 25% |
| Scientists | 1 | 8% |
Mendeley readers
The data shown below were compiled from readership statistics for 18 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 18 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 4 | 22% |
| Student > Doctoral Student | 2 | 11% |
| Student > Bachelor | 1 | 6% |
| Unspecified | 1 | 6% |
| Professor > Associate Professor | 1 | 6% |
| Other | 1 | 6% |
| Unknown | 8 | 44% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 6 | 33% |
| Social Sciences | 2 | 11% |
| Nursing and Health Professions | 1 | 6% |
| Unspecified | 1 | 6% |
| Engineering | 1 | 6% |
| Other | 0 | 0% |
| Unknown | 7 | 39% |
Attention Score in Context
This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 August 2018.
All research outputs
#5,093,305
of 25,208,845 outputs
Outputs from Journal of Pain Research
#540
of 1,955 outputs
Outputs of similar age
#89,504
of 332,525 outputs
Outputs of similar age from Journal of Pain Research
#17
of 53 outputs
Altmetric has tracked 25,208,845 research outputs across all sources so far. Compared to these this one has done well and is in the 79th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,955 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.1. This one has gotten more attention than average, scoring higher than 72% of its peers.
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We're also able to compare this research output to 53 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.