Intrathecal Dexmedetomidine Combined With Ropivacaine in Cesarean Section: A Prospective Randomized Double-Blind Controlled Study

Frontiers in Medicine

article

Qian Zhang¹  Ling-yi Xia¹  Wei-dong Liang³  Ding-yu Rao⁴  Ping-ping Zhu³  Ke-nv Huang¹  Zi-hao Deng¹  Mao-lin Zhong³ 

[1] First Clinical Medical College, Gannan Medical University;Department of Anesthesiology, Nanjing Gulou Hospital Group Suqian Hospital Co., Ltd.;Department of Anesthesiology, The First Affiliated Hospital of Ganna Medical University;Department of Thoracic Surgery, The First Affiliated Hospital of Ganna Medical University

关键词: cesarean section;    dexmedetomidine;    ropivacaine;    spinal anesthesia;    adverse effects;   

DOI  :  10.3389/fmed.2022.922611

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective This study aimed to find the best dose of dexmedetomidine in spinal anesthesia for cesarean section. Methods 120 American Society of Anesthesiologists (ASA) Class I and II parturients undergoing elective cesarean delivery under spinal anesthesia were randomly allocated into four groups treated with intrathecal ropivacaine (12 mg) alone (Group R) or in combination with dexmedetomidine 5 μg (Group RD1), 7.5 μg (Group RD2) and 10 μg (Group RD3). Characteristics of spinal anesthesia, hemodynamic changes, adverse effects, stress reactions and neonatal outcomes were recorded in the four groups. Results Patients in Group RD1, RD2, and RD3 had significantly longer sustained sensory and motor block time than patients in Group R. All four groups had comparable onset times of sensory and motor block. The time for the level of sensory block to lower to S1 was longer in Group RD1 (411.07 ± 106.66 min), Group RD2 (397.03 ± 125.39 min) and Group RD3 (468.63 ± 116.43 min) than in Group R (273.60 ± 88.34 min) ( p 0.05). There was no statistically significant visceral traction response or fentanyl use in the four groups ( p > 0.05). Phenylephrine dosing was significantly higher in Group RD2 and RD3 than in Group R ( p 0.05). There were no statistical differences in postnatal Apgar scores (1 min, 5 min after birth) ( p > 0.05). The postoperative concentrations of β-endorphin (β-EP), cortisol (Cor) and tumor necrosis factor-α (TNF-α) in the Group RD1, RD2, and RD3 were lower than that in Group R ( p < 0.05). Conclusion Intrathecal 5μg of dexmedetomidine as an adjuvant to ropivacaine relieved intraoperative chills, did not increase intraoperative and postoperative adverse effects, did not increase the amount of intraoperative vasoconstrictor used, and reduced intraoperative stress reactions as well as prolonged the duration of maternal sensory and motor block, so this dose is appropriate for cesarean section.

【 授权许可】

CC BY