Volume 7 Issue 3
May  2016
Turn off MathJax
Article Contents
Jia-ying XU, Yu ZHANG, Xiu-hua ZHANG, Chen-wei FU, Jun-tao LIU, Yu-guang HUANG. Effect of Intravenous Dexmedetomidine on Intraoperative Sedation and Adverse Events in Cesarean Section[J]. Medical Journal of Peking Union Medical College Hospital, 2016, 7(3): 176-179. doi: 10.3969/j.issn.1674-9081.2016.03.003
Citation: Jia-ying XU, Yu ZHANG, Xiu-hua ZHANG, Chen-wei FU, Jun-tao LIU, Yu-guang HUANG. Effect of Intravenous Dexmedetomidine on Intraoperative Sedation and Adverse Events in Cesarean Section[J]. Medical Journal of Peking Union Medical College Hospital, 2016, 7(3): 176-179. doi: 10.3969/j.issn.1674-9081.2016.03.003

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

doi: 10.3969/j.issn.1674-9081.2016.03.003
More Information
  • Corresponding author: HUANG Yu-guang   Tel: 010-69152020, E-mail: garybeijing@163.com
  • Received Date: 2015-08-25
  • Publish Date: 2016-05-30
  •   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.
  • loading
  • [1] Gizzo S, Noventa M, Fagherazzi S, et al. Update on best available options in obstetrics anesthesia: perinatal outcomes, side effects and maternal satisfaction: fifteen years systematic literature review[J]. Arch Gynecol Obstet, 2014, 290:21-34. doi:  10.1007/s00404-014-3212-x
    [2] Kim JM, Kim WO, Kim HB, et al. Adequate sedation with single-dose dexmedetomidine in patients undergoing transurethral resection of the prostate with spinal anesthesia: a dose-response study by age group[J]. BMC Anesthesiol, 2015, 27;15-17. doi:  10.1186/1471-2253-15-17
    [3] Basar H, Akpinar S, Doganci N, et al. The effects of preanesthetic, single-dose dexmedetomidine on induction, hemodynamic, and cardiovascular parameters[J]. J Clin Anesth, 2008, 20: 431-436. doi:  10.1016/j.jclinane.2008.04.007
    [4] Peden CJ, Cloote AH, Stratford N, et al. The effect of intravenous dexmedetomidine premedication on the dose requirement of propofol to induce loss of consciousness in patients receiving alfentanil[J]. Anaesthesia, 2001, 56: 408-413. doi:  10.1046/j.1365-2044.2001.01553.x
    [5] Esmaoglu A, Yegenoglu F, Akin A, et al. Dexmedetomidine added to levobupivacaine prolongs axillary brachial plexus block[J]. Anesth Analg, 2010, 111:1548-1551. doi:  10.1213/ANE.0b013e3181fa3095
    [6] Faraj W, Abdallah AA, Brull R. The facilitatory effects of intravenous dexmedetomidine on the duration of spinal anesthesia: a systematic review and meta-analysis[J]. Anesth Analg, 2013, 117:271-278. doi:  10.1213/ANE.0b013e318290c566
    [7] Keating GM. Dexmedetomidine: a review of its use for sedation in the intensive care setting[J]. Drugs, 2015, 75:1119-1130. doi:  10.1007/s40265-015-0419-5
    [8] Adams R, Brown GT, Davidson M, et al. Efficacy of dexmedetomidine compared with midazolam for sedation in adult intensive care patients: a systematic review[J]. Br J Anaesth, 2013, 111:703-710. doi:  10.1093/bja/aet194
    [9] Nie Y, Liu Y, Luo Q, et al. Effect of dexmedetomidine combined with sufentanil for post-caesarean section intravenous analgesia: a randomised, placebo-controlled study[J]. Eur J Anaesthesiol, 2014, 31:197-203. http://cn.bing.com/academic/profile?id=7ff4ceb5c9c2eaff9b9f8b5ec8f70b21&encoded=0&v=paper_preview&mkt=zh-cn
    [10] Ickeringill M, Shehabi Y, Adamson H, et al. Dexmedetomidine infusion without loading dose in surgical patient requiring mechanical ventilation: haemodynamic effect and efficacy[J]. Anaesth Intensive Care, 2004, 32: 741-745. doi:  10.1177/0310057X0403200602
    [11] Bajwa SJ, Gupta S, Kaur J, et al. Reduction in the incidence of shivering with perioperative dexmedetomidine: a randomized prospective study[J]. J Anaesthesiol Clin Pharmacol, 2012, 28:86-91. doi:  10.4103/0970-9185.92452
    [12] Yu M, Han C, Jiang X, et al. Effect and placental transfer of dexmedetomidine during caesarean section under general anesthesia[J]. Basic Clin Pharmacol Toxicol, 2015, 117:201-208. https://pubmed.ncbi.nlm.nih.gov/25652672/
    [13] Yousef AA, Salem HA, Moustafa MZ. Effect of mini-dose epidural dexmedetomidine in elective cesarean section using combined spinal-epidural anesthesia: a randomized double-blinded controlled study[J]. J Anesth, 2015, 29:708-714. doi:  10.1007/s00540-015-2027-7
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(2)

    Article Metrics

    Article views (164) PDF downloads(5) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return