Effectiveness of intrathecal dexmedetomidine for pregnant women undergoing cesarean section

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Created On: 16/09/2020

Effectiveness of intrathecal dexmedetomidine for pregnant women undergoing cesarean section

The effectivess of DEX via intrathecal administration for expectants/parturients undergoing CS has been examined in this study.

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Key take away

Evading the maternal risk of general anesthesia is of utmost importance during cesarean section (CS). As observed from this double-blind randomized controlled study, the combination of 5 μg of dexmedetomidine (DEX) for CS could considerably prolong the extent of sensory block by 40 minutes alongwith better recovery and no neonatal adverse effects or maternal neurotoxicity in the short term than bupivacaine (BUP) 9 mg alone. The use of DEX can also decrease the occurence of shivering in expectants enduring spinal anesthesia.

Background

The effectivess of DEX via intrathecal administration for expectants/parturients undergoing CS has been examined in this study.

Method

On the whole, 300 expectants undergoing CS via spinal anesthesia were randomized into 3 groups in specific concentrations:

Group B: 9.0 mg (1.2 ml) of 0.75% BUP with saline (1 ml);
Group FB: 9.0 mg (1.2 ml) of 0.75% BUP with 20 μg of fentanyl (1 ml);
Group DB: 9.0 mg (1.2 ml) of 0.75% BUP with 5 μg of DEX (1 ml).

The features of intraoperative block, recovery quality, maternal and neonatal outcomes and plasma concentrations were all calculated. A 30 days follow-up helped to provide a clear view regarding occurence of nerve injury (if any).

Result

The period of sensory block protracted in group FB and group DB compared to group B. In group DB, the total score of quality recovery was significantly higher than that in group FB and group B. A detail of the block characteristics of expectants has been displayed in following figure:

Figure: Block characteristics of expectants

Amid 3 groups, no statistically significant difference for PH, PaO2, and PaCO2 of newborn was observed. Plasma concentration of DEX in umbilical artery and vein was almost negligible and cannot be perceived. After 30 days, no new inception of back, buttock or leg pain or paresthesia was witnessed in these women.