Comparison of postoperative analgesic effects in response to either dexamethasone or dexmedetomidine as local anesthetic adjuvants: a systematic review and meta-analysis of randomized controlled trials.

This review compares the effects of peripheral dexamethasone and dexmedetomidine on postoperative analgesia. We included six randomized controlled trials (354 patients) through a systematic literature search. We found that analgesia duration was comparable between dexamethasone and dexmedetomidine (58.59 min, 95% CI (confidence interval), - 66.13, 183.31 min) with extreme heterogeneity. Secondary outcome was also compared and no significant difference was observed in sensory block onset and duration and motor block duration and also for postoperative nausea and vomiting. It is noteworthy that dexamethasone reduced analgesic consumption (fentanyl) by 29.12 mcg compared with dexmedetomidine. We performed subgroup analyses and found no significant difference between the following: (1) lidocaine vs ropivacaine (P = 0.28), (2) nerve block vs nerve block + general anesthesia (P = 0.47), and (3) upper limb surgery vs thoracoscopic pneumonectomy (P = 0.27). We applied trial sequential analysis to assess the risks of type I and II errors and concluded that the meta-analysis was insufficiently powered to answer the clinical question, and further analysis is needed to establish which adjuvant is better. In conclusion, we believe that existing research indicates that dexamethasone and dexmedetomidine have equivalent analgesic effects in peripheral nerve blocks.

The rice planthopper parasitoid Anagrus nilaparvatae is not at risk when feeding on honeydew derived from Bacillus thuringiensis (Bt) rice.

BACKGROUND: Honeydew is a sugar-rich excretion produced by sap-feeding Sternorrhyncha and is an important source of carbohydrates for natural enemies, especially for parasitoids. Honeydew derived from genetically modified (GM) crops can contain amounts of the transgene product. Thus, it is a possible route of exposure for natural enemies feeding on honeydew. In the present study, the potential effects of Nilaparvata lugens honeydew derived from Cry1C and Cry2A rice on different life-table parameters and parasitism dynamics of the egg parasitoid Anagrus nilaparvatae were evaluated under laboratory and field conditions. Furthermore, the Bacillus thuringiensis (Bt) levels and the sugar and amino acid composition of honeydew were analyzed. RESULTS: Results indicated that A. nilaparvatae was exposed to Bt proteins by feeding on N. lugens honeydew produced from Bt rice. However, honeydew derived from the tested Cry1C and Cry2A rice lines did not affect the development, longevity, emergence rate and fecundity of A. nilaparvatae. Also, the parasitism dynamics in the field remained unaffected. In addition, the sugar and amino acid composition of N. lugens honeydew was not significantly altered for the tested Bt rice lines compared with the parental non-Bt plant. CONCLUSION: The quality of honeydew derived from the tested Bt rice lines as a food resource for natural enemies was maintained. © 2018 Society of Chemical Industry.