SHM Converge Scientific Abstract ePoster Gallery-Barbiturates in the Management of Alcohol Withdrawal Syndrome: A Systematic Review and Meta-Analysis.

Pdf Summary

This systematic review and meta-analysis evaluated whether barbiturates are effective and safe for managing alcohol withdrawal syndrome, either alone or combined with benzodiazepines. Because benzodiazepines are the standard first-line treatment, the authors sought stronger evidence for the growing use of barbiturates, especially phenobarbital.<br /><br />The researchers searched PubMed, EMBASE, Cochrane, and Web of Science through October 2020 and included 10 studies involving 1,279 patients. The evidence base consisted of 2 randomized controlled trials and 8 retrospective cohort studies. Half of the studies were conducted in emergency department settings and half in inpatient settings. Comparisons included barbiturates versus benzodiazepines and barbiturates as adjunct therapy versus benzodiazepines alone.<br /><br />Overall, pooled results showed no significant difference in emergency department discharge rates, ICU admissions, seizure prevention, or mortality when barbiturates were used alone or as adjunct therapy. In hospitalized patients, barbiturate use was associated with a shorter hospital stay by about 1.92 days. However, no reduction in intubation rates or mortality was seen. When barbiturates were used alone, intubation rates were higher compared with benzodiazepines, suggesting greater caution is needed with monotherapy.<br /><br />The authors concluded that barbiturates may be used safely as an alternative or adjunct treatment in emergency department settings, with no clear disadvantage in key short-term outcomes. In inpatient settings, adjunct barbiturate therapy may reduce length of stay. However, barbiturate monotherapy should be used carefully due to the higher intubation risk. The review emphasizes the need for more randomized controlled trials to better define the role of barbiturates in alcohol withdrawal management.

Asset Subtitle

Abhishek Matta

Meta Tag

Author List Abhishek Matta, Arjun Saradna, Avantika Rudraraju, Manoj Mammen, Rajesh Kunadharaju

Category Research

Concept Barbiturates

Concept Alcohol Withdrawal Syndrome

Concept Benzodiazepines

Concept Seizure Prevention

Concept Hospital Length of Stay

Distinguished Non-Finalist

Presenter Organization Sanford Health/University of North Dakota School of Medicine

Presenting Author Abhishek Matta

Track Outcomes Research

Keywords

barbiturates

phenobarbital

alcohol withdrawal syndrome

benzodiazepines

systematic review

meta-analysis

adjunct therapy

intubation risk

hospital length of stay

emergency department

Barbiturates

Alcohol Withdrawal Syndrome

Benzodiazepines

Seizure Prevention

Hospital Length of Stay