Intravenous Dexmedetomidine as an Adjunct to Neuraxial Anesthesia in Cesarean Delivery: A Retrospective Chart Review.

IF 1.6 Q2 ANESTHESIOLOGY
Anesthesiology Research and Practice Pub Date : 2021-12-27 eCollection Date: 2021-01-01 DOI:10.1155/2021/9887825
Paul R Davis, Hans P Sviggum, Daniel J Delaney, Katherine W Arendt, Adam K Jacob, Emily E Sharpe
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引用次数: 3

Abstract

Background: Dexmedetomidine is a selective α-2 agonist commonly used for sedation that has been used in obstetric anesthesia for multimodal labor analgesia, postcesarean delivery analgesia, and perioperative shivering. This study evaluated the role of intravenous dexmedetomidine to provide rescue analgesia and/or sedation during cesarean delivery under neuraxial anesthesia.

Methods: We conducted a single-center, retrospective cohort study of all parturients undergoing cesarean delivery under neuraxial anesthesia between December 1, 2018, and November 30, 2019, who required supplemental analgesia during the procedure. Patients were divided into two groups: patients who received intravenous dexmedetomidine (Dexmed group) and patients who received adjunct medications such as fentanyl, midazolam, ketamine, and nitrous oxide (Standard group). Primary outcome was incidence of conversion to general anesthesia.

Results: During the study period, 107 patients received adjunct medications. There was no difference in conversion to general anesthesia between the Dexmed group and the Standard group (6% (4/62) vs. 9% (4/45); p=0.718). In the Dexmed group, the mean dexmedetomidine dose received was 37 μg (range 10 to 140 μg). While the use of inotropic/vasopressor medications was common and similar in both groups, there was an increase in the incidence of bradycardia (Dexmed 15% vs. Standard 2%; p=0.042) but not hypotension (Dexmed 24% vs. Standard 24%; p=1.00) in the Dexmed group.

Conclusion: In patients who required supplemental analgesia for cesarean delivery, those who received dexmedetomidine versus other medications had a similar rate of conversion to general anesthesia, a statistically significant increase in bradycardia, but no difference in the incidence of hypotension.

Abstract Image

Abstract Image

剖宫产中静脉注射右美托咪定辅助轴向麻醉:回顾性图表回顾。
背景:右美托咪定是一种选择性α-2激动剂,常用于镇静,在产科麻醉中用于多模式分娩镇痛、剖宫产后镇痛和围手术期寒战。本研究评估了静脉注射右美托咪定在剖宫产神经轴麻醉下的镇痛和/或镇静作用。方法:我们对2018年12月1日至2019年11月30日期间需要补充镇痛的所有在轴向麻醉下剖宫产的孕妇进行了一项单中心、回顾性队列研究。患者分为静脉注射右美托咪定组(右美托咪定组)和芬太尼、咪达唑仑、氯胺酮、氧化亚氮等辅助药物组(标准组)。主要观察指标为转全身麻醉的发生率。结果:在研究期间,107例患者接受了辅助药物治疗。Dexmed组和Standard组转到全麻的比例无差异(6% (4/62)vs. 9% (4/45);p = 0.718)。右美托咪定组平均给药剂量为37 μg (10 ~ 140 μg)。虽然在两组中使用肌力/血管加压药物很常见且相似,但心动过缓的发生率增加(Dexmed组15% vs.标准组2%;p=0.042),但没有出现低血压(Dexmed 24% vs. Standard 24%;p=1.00)。结论:在剖宫产需要补充镇痛的患者中,接受右美托咪定与其他药物的患者转化为全身麻醉的比率相似,心动过缓的发生率有统计学意义的显著增加,但低血压的发生率无差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
29
审稿时长
18 weeks
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