Dexmedetomidine Combined With Local Anesthestic Uses For Brachial Plexus Block:a Systematic Review And Meta-analysis

Background :Brachial plexus block could have a good effect on the anesthesia and analgesia of upper arm surgery,dexmedetomidine could prolong the duration of brachial plexus block,but the results of research are different.Now,we make this review and meta analysis of the effect of dexmedetomidine for brachial plexus block,making out a quantitative analysis of dexmedetomiding by statistical methods.Methods:We search electronic database by keywords,intending to find randomized controlled trials that investigated the addition of dexmedetomidine to peripheral nerve compared with local anesthetic alone in brachial plexus block.We evaluate the duration of sensory and motor nerve block and the onset time of block and the duration of analgesia.We use random effect model to pool WMD of each research and 95% confidence interval.Results:We identified 22 random controlled trials(1449 patients),found that dexmedetomidine prolonged sensory block(WMD 214 minutes,95%CI 171-258,P<0.00001),motor block(WMD 172 minutes,95%CI 121-22,P<0.00001),analgesia(WMD 241 minutes,95%CI 185-297,P<0.00001)when used for peripheral nerve;Dexmedtomidine expedited onset for both sensory(WMD-3.26 minutes,95%CI-4.21—2.30,P<0.00001),motor(WMD-3.77 minutes,95%CI-4.92—2.63,P<0.00001);There were no evidence that dexmedetomidine for peripheral nerve result in irreversible side effects.Conclusions :Dexmedetomidine could enhance the effect of brachial plexus block,but may cause transient bradycardia and hypotension.Further research is needed to confirm the dexmedetomidine.