Comparison of the postoperative analgesic effects of intrathecal Clonidine and Fentanyl as adjuvant: Mata Analysis of randomized control trials

Abstract

Background: Intrathecal clonidine and fentanyl added to bupivacaine prolongs the postoperative analgesic effects for below umbilicus surgery. However, the overall effect of clonidine and fentanyl mixed with spinal anesthesia is not harmonized. Therefore, the aim of this Meta - analysis was to assess the post operative analgesic effects of intrathecal clonidine and fentanyl for different randomized control trials of study. Methods: Pubmed, Cochrane Review, EMBASE, and Google Scholar were searched and a total of four studies have been selected for Meta – Analysis. Three authors engaged independently to extract data on the efficacy of intrathecal clonidine and fentanyl for lower abdomen and limb surgeries. The statistical analysis was accomplished by RevMan (version 5.3) software. The overall efficacy of intrathecal clonidine and fentanyl were pooled by Forrest plot, table, and figure with 95% confidence interval. Results: The pooled effect size mean difference of intrathecal clonidine versus fentanyl was 83.57(95 % CI, 29.33 to 137.82) minutes. Furthermore, the lowest and highest mean difference of effect size was 10.60 and 175.98 minutes respectively. Conclusion: Intrathecal clonidine as adjuvant to bupivacaine gave the prolonged postoperative analgesia in comparison to intrathecal fentanyl. So it is recommended to use clonidine as intrathecal adjuvant when we consider the extended postoperative analgesia.