Effect of Intravenous Dexmedetomidine on Intraoperative Sedation and Adverse Events in Cesarean Section

  Objective  To evaluate the effect of intravenous dexmedetomidine on intraoperative sedation and adverse events in parturients undergoing Cesarean section using combined spinal-epidural anesthesia.

  Methods  Fifty singleton parturients at term scheduled for Cesarean section under combined spinal-epidural anesthesia were allocated to two groups using random numbers:dexmedetomidine group(study group, n=25) and normal saline group(control group, n=25). All the parturients received 0.5% hyperbaric bupivacaine 8 mg intrathecally following subarachnoid puncture. After delivery of the baby, the study group received dexmedetomidine 1 μg/kg intravenous bolus infusion for 10 minutes followed by 0.5 μg/(kg·h) continuous infusion until the end of surgery, whereas the control group was infused with equivalent amount of normal saline. Ramsay scores were recorded every 30 minutes during the surgery. The incidence of intraoperative adverse events and adverse drug reactions were also recorded, as well as 1-minute and 5-minute Apgar scores of the newborns.

  Results  Ramsay score of the study group was significantly higher than that of the control group (3.4±0.7 vs. 2.2±0.4, P=0.001). Incidences of shivering (0 vs. 16%, P=0.001), nausea and vomiting (8% vs. 36%, P=0.019), abdominal discomfort upon surgical traction (12% vs. 48%, P=0.006) in the study group were all significantly lower than those in the control group. In terms of adverse drug reactions, incidence of bradycardia in the study group was higher than that in the control group (24% vs. 0, P=0.011), while incidences of hypotension, oversedation, and respiratory depression showed no significant difference between the two groups. Apgar scores of the two groups also showed no significant difference.

  Conclusions  Intravenous dexmedetomidine could improve intraoperative sedative effect in parturients undergoing Cesarean section under combined spinal-epidural anesthesia and reduce the incidence of intraoperative adverse events with little adverse reaction and no influence on neonates.