{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T19:48:03Z","timestamp":1780343283989,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T00:00:00Z","timestamp":1635292800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evidence-Based Complementary and Alternative Medicine"],"published-print":{"date-parts":[[2021,10,27]]},"abstract":"<jats:p>Background. This study aims to determine the analgesic effect and safety of dexmedetomidine as an adjuvant to epidural local anesthetics during labor. Methods. Randomized controlled trials comparing epidural blocks with or without dexmedetomidine for labor analgesia were comprehensively searched. Review manager 5.4 was used to analyze the extracted data. Results. Compared with placebo and opioids, dexmedetomidine relieved labor pain of 15\u2009min (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>P<\/a:mi>\n                        <a:mo>=<\/a:mo>\n                        <a:mn>0.002<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>), 30\u2009min (<jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>P<\/c:mi>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.01<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>), and 120\u2009min (<jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>P<\/e:mi>\n                        <e:mo>=<\/e:mo>\n                        <e:mn>0.02<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>) after block and at the moment of fetal disengagement (<jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>P<\/g:mi>\n                        <g:mo>=<\/g:mo>\n                        <g:mn>0.0002<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>), decreased mean arterial pressure of 120\u2009min (<jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>P<\/i:mi>\n                        <i:mo>=<\/i:mo>\n                        <i:mn>0.01<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>), heart rate of 30\u2009min (<jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mi>P<\/k:mi>\n                        <k:mo>=<\/k:mo>\n                        <k:mn>0.003<\/k:mn>\n                     <\/k:math>\n                  <\/jats:inline-formula>), 60\u2009min (<jats:inline-formula>\n                     <m:math xmlns:m=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                        <m:mi>P<\/m:mi>\n                        <m:mo>&lt;<\/m:mo>\n                        <m:mn>0.00001<\/m:mn>\n                     <\/m:math>\n                  <\/jats:inline-formula>), and 120\u2009min (<jats:inline-formula>\n                     <o:math xmlns:o=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\">\n                        <o:mi>P<\/o:mi>\n                        <o:mo>&lt;<\/o:mo>\n                        <o:mn>0.00001<\/o:mn>\n                     <\/o:math>\n                  <\/jats:inline-formula>) after block, blood loss (<jats:inline-formula>\n                     <q:math xmlns:q=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\">\n                        <q:mi>P<\/q:mi>\n                        <q:mo>=<\/q:mo>\n                        <q:mn>0.02<\/q:mn>\n                     <\/q:math>\n                  <\/jats:inline-formula>), and the incidence of nausea\/vomiting (<jats:inline-formula>\n                     <s:math xmlns:s=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\">\n                        <s:mi>P<\/s:mi>\n                        <s:mo>=<\/s:mo>\n                        <s:mn>0.006<\/s:mn>\n                     <\/s:math>\n                  <\/jats:inline-formula>), and increased the incidence of maternal bradycardia (<jats:inline-formula>\n                     <u:math xmlns:u=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M11\">\n                        <u:mi>P<\/u:mi>\n                        <u:mo>=<\/u:mo>\n                        <u:mn>0.04<\/u:mn>\n                     <\/u:math>\n                  <\/jats:inline-formula>). However, sensitivity analysis only found that the incidence of nausea\/vomiting was significantly different. Compared with placebo, dexmedetomidine relieved labor pain of 30\u2009min after block (<jats:inline-formula>\n                     <w:math xmlns:w=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M12\">\n                        <w:mi>P<\/w:mi>\n                        <w:mo>&lt;<\/w:mo>\n                        <w:mn>0.00001<\/w:mn>\n                     <\/w:math>\n                  <\/jats:inline-formula>) and did not increase the incidences of side effects, but only two studies were enrolled. Compared with opioids, dexmedetomidine decreased the incidence of nausea\/vomiting (<jats:inline-formula>\n                     <y:math xmlns:y=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M13\">\n                        <y:mi>P<\/y:mi>\n                        <y:mo>=<\/y:mo>\n                        <y:mn>0.002<\/y:mn>\n                     <\/y:math>\n                  <\/jats:inline-formula>), increased the incidence of maternal bradycardia (<jats:inline-formula>\n                     <ab:math xmlns:ab=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M14\">\n                        <ab:mi>P<\/ab:mi>\n                        <ab:mo>=<\/ab:mo>\n                        <ab:mn>0.04<\/ab:mn>\n                     <\/ab:math>\n                  <\/jats:inline-formula>), and had a similar effect on labor pain relief; however, sensitivity analysis found that significant difference existed only at the incidence of nausea\/vomiting. Other outcomes from meta-analysis or subgroup analysis were not different. Conclusions. Epidural dexmedetomidine has the potential to offer a better analgesic effect than placebo, similar labor pain control to opioids, and has no definite adverse effects on the parturient or fetus, but more high-quality studies are needed to confirm these conclusions.<\/jats:p>","DOI":"10.1155\/2021\/4886970","type":"journal-article","created":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T19:20:07Z","timestamp":1635448807000},"page":"1-11","source":"Crossref","is-referenced-by-count":11,"title":["Effect of Epidural Dexmedetomidine as an Adjuvant to Local Anesthetics for Labor Analgesia: A Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8951-3301","authenticated-orcid":true,"given":"Nijuan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Sichuan Jinxin Women and Children Hospital, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4717-5858","authenticated-orcid":true,"given":"Li","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Sichuan Jinxin Women and Children Hospital, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8012-8191","authenticated-orcid":true,"given":"Chunping","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Sichuan Jinxin Women and Children Hospital, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9014-0255","authenticated-orcid":true,"given":"Xuelin","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Sichuan Jinxin Women and Children Hospital, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1365-8720","authenticated-orcid":true,"given":"Yong","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Sichuan Jinxin Women and Children Hospital, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2015.12.004"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aev325"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.4066\/biomedicalresearch.29-17-2921"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1177\/0300060517698330"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2016\/22674.8857"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd000331.pub3"},{"key":"7","first-page":"9","article-title":"Combined spinal-epidural for labor analgesia with low-dose bupi- vacaine but without any opioid in the spinal component: can we improve upon the traditional?","volume":"66","author":"S. 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