Clonidine and Morphine as Adjuvants for Caudal Anaesthesia in Children: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.
Anaesthesia
analgesia
caudal
children
clonidine
morphine
Journal
Turkish journal of anaesthesiology and reanimation
ISSN: 2667-677X
Titre abrégé: Turk J Anaesthesiol Reanim
Pays: Turkey
ID NLM: 101680817
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
27
06
2019
accepted:
05
09
2019
entrez:
1
9
2020
pubmed:
31
8
2020
medline:
31
8
2020
Statut:
ppublish
Résumé
The aim of this systematic review and meta-analysis is to compare the outcomes of morphine vs. clonidine use as adjuvants in caudal anaesthesia. We are specifically focused on analgesic and side effect profiles. We searched databases and trial registration sites and include here randomised controlled trials that compare the analgesic effects of caudal clonidine vs. morphine as adjuvants on postoperative pain. The risk ratio for evaluating pain scores, the need for rescue analgesia and all adverse effects were assessed. The i2 statistic was used to assess heterogeneity. We also assessed risk of bias with Cochrane's Collaboration tool. The quality of evidence was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Four randomised controlled trials (including 166 patients) that evaluated the use of clonidine vs. morphine as adjuvants in caudal block were included in this systematic review and meta-analysis. The pooled estimate for postoperative analgesia revealed no statistically significant differences between the clonidine group compared to morphine group (MD=2.90; 95% CI 4.05 to 9.85; i2 93%). Significantly less postoperative nausea and vomiting were reported among the patients that received clonidine vs. those that were treated with morphine (RR 0.57, 95% CI -0.36 to -0.90, i2 26%). There were no statistically significant differences between the two groups in assessments that included urinary retention, pain scores or need for rescue analgesia at 24 hours. Clonidine is just as effective as morphine when used an adjuvant to local anaesthetic for caudal block, and has a more desirable side effect profile, particularly with respect to postoperative nausea and vomiting.
Identifiants
pubmed: 32864640
doi: 10.5152/TJAR.2020.29863
pii: tard-48-4-265
pmc: PMC7434346
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
265-272Informations de copyright
© Copyright 2020 by Turkish Anaesthesiology and Intensive Care Society.
Déclaration de conflit d'intérêts
Conflict of Interest: The authors have no conflicts of interest to declare.
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