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Background: Although clonidine and dexmedetomidine are used as alpha-2 agonists to improve the quality and duration of blockade induced by local anesthetics, no study has been reported to compare their associated adverse events in local anesthesia. The aim of this study is to compare the adverse events associated with the adjuvant use of dexmedetomidine and clonidine in local anesthesia.Methods: A comprehensive search was performed to retrieve any reported adverse event associated with adjuvant use of dexmedetomidine and clonidine in local anesthesia from published literature up to 1 July 2020. Assessment of the quality of included studies was performed by the Jadad score. A comparison of any reported adverse event was made between interventions by pooling data from studies using a direct meta-analysis technique. Dichotomous outcomes were summarized as risk ratios. The review was performed according to PRISMA guideline.Results: From 121 articles retrieved from the search finally 14 articles including 1,120 patients had eligibility criteria for including in the meta-analysis. No significant difference was observed between bradycardia/hypotension (OR = 1.17; 95 % CI = 0.66–2.10; P = 0.580; I2 = 53.78 %, P = 0.027), nausea/vomiting (OR = 0.91; 95% CI = 0.59-1.42; P = 0.706; I2 = 0.0 %, P = 0.940) dizziness/headache (OR = 1.10; 95% CI = 0.44–2.75; P = 0.831; I2 = 0.0 %, P = 0.882) shivering (OR = 0.95 % CI = 0.50–1.66; P = 0.831; I2 = 0.0 %, P = 0.920) and dry mouth (OR = 1.00; 95 % CI = 0.50–1.96; P = 0.996; I2 = 0.0%, P = 0.900). No significant difference was observed in subgroup comparison of adverse events in the intravenous or local adjuvant use of the study drugs (p > 0.05).Conclusion: There is no difference in adverse events associated with the intravenous or local adjuvant use of dexmedetomidine and clonidine in local anesthesia.
ObjectiveThis study aimed to evaluate the efficacy of transversus abdominis plane block (TAPB) in patients after laparoscopic radical cervical cancer surgery.MethodsA total of 120 patients with cervical cancer who underwent laparoscopic radical resection in the hospital from January 2019 to January 2020 were selected and concurrently assigned to either patient-controlled intravenous analgesia (PCIA) (Control group) or PCIA plus TAPB (Observation group) according to different methods. The visual analogscale (VAS), Bruggemann comfort scale (BCS), immune function indicators, hemodynamics, analgesia indicators, and postoperative recovery time were recorded and compared.ResultsThe Observation group had a lower VAS score and a higher BCS postoperatively compared with the Control group, and the difference was statistically significant. After the operation, immune function indexes of patients in the two groups were declined, and the difference was statistically significant. At 76 h after operation, the immune function indexes of the Control group were lower than the Observation group, and the difference was statistically significant. After the operation, the Control group obtained a higher mean arterial pressure (MAP) at extubation, and the difference was statistically significant. The Observation group outperformed the Control group in terms of analgesia indicators and postoperative recovery time, and the difference was statistically significant.ConclusionTAPB can enhance the analgesic effect of patients after laparoscopic radical resection of cervical cancer, stabilize their physical signs, has little effect on the patient's immune function, with a high safety profile.
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