Dexmedetomidine for every Cesarean delivery…maybe not?

Bautista, Lesley; George, Ronald B.

doi:10.1007/s12630-019-01355-2

Cited by 7 publications

(5 citation statements)

References 23 publications

(37 reference statements)

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“…At the same time, maternal anxiety, chills, nausea, and vomiting are prone to adverse reactions during cesarean section [ 10 ]. Studies have shown that intraoperative use of a certain dose of dexmedetomidine (intravenous infusion started after the fetus is born) to assist sedation can prevent the onset of chills and significantly reduce maternal uterine contraction due to drugs [ 11 ]. The incidence of adverse reactions such as nausea and vomiting caused by the use of the puerperium and the surgical traction reaction is conducive to maintaining the stability of the intraoperative circulation and does not affect breathing, while the puerperal has stable breathing and circulation [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

The Anesthetic Effect and Safety of Dexmedetomidine in Cesarean Section: A Meta-Analysis

Pang

Zhu

Yan

et al. 2022

BioMed Research International

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Objective. To evaluate the anesthetic effect and safety of dexmedetomidine in cesarean section. Methods. The Cochrane Library, EMBASE, and PubMed databases (established until September 2020) were searched by computer. Two authors independently screened and extracted literature related to the application of dexmedetomidine in the cesarean section according to inclusion and exclusion criteria. The control group received either subarachnoid block (lumbar anesthesia) or combined lumbar anesthesia and epidural anesthesia (combined lumbar epidural anesthesia) with bupivacaine or combined bupivacaine and fentanyl. The observation group was additionally given dexmedetomidine based on the control group, to analyze the anesthetic effect and safety of dexmedetomidine in cesarean section. Results. A total of 580 cesarean delivery women were included in 8 studies, and the results showed that the peak time of sensory block in the observation group was shorter than that in the control group (standard mean difference = − 0.28 ; 95% confidence interval: -0.48, -0.08; P = 0.006 ), sensory block lasted longer than that in the control group (standard mean difference = 1.49 ; 95% confidence interval: 1.21, 1.78; P < 0.00001 ), the sedation rate was higher than that in the control group, the onset of the first postoperative pain was significantly delayed compared with that in the control group, and the incidence of postoperative pain, nausea and vomiting, postoperative chills, and fever was lower than that in the control group ( P < 0.05 ). Conclusion. Dexmedetomidine combined with lumbar anesthesia or combined lumbar epidural anesthesia for women in cesarean section has more clinical benefits and better safety.

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Section: Introductionmentioning

confidence: 99%

The Anesthetic Effect and Safety of Dexmedetomidine in Cesarean Section: A Meta-Analysis

Pang

Zhu

Yan

et al. 2022

BioMed Research International

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“…Butorphanol produces more drowsiness, nausea, vomiting, and shivering than fentanyl. Fentanyl is more efficient and less time-consuming in preventing perioperative shivering than butorphanol [13]. Table 3 shows that 9 mg of bupivacaine resulted in a non-significant difference (p=0.987) in shivering between groups; however, the other doses resulted in a significant difference, with 10, 11, 12, and 13 mg doses exhibiting considerably higher shivering.…”

Section: Discussionmentioning

confidence: 99%

Fentanyl Versus Ondansetron for Shivering Prevention in Cesarean Section: A Comparative Study

Hasan,

Haji Qadir,

Mohammed

2023

Cureus

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Background and purpose: The incidence of postoperative shivering (PS) following intrathecal anesthesia is a common complication, with potential negative impacts on patient outcomes. This study aims to evaluate the effectiveness of intrathecal fentanyl versus intravenous ondansetron in preventing post-spinal anesthesia shivering in cesarean section patients.Experimental approach: A randomized controlled trial was conducted from July 2021 to April 2023, involving pregnant women scheduled for cesarean section under intrathecal anesthesia. The participants were divided into three groups: group F received intrathecal fentanyl (15 μg) with spinal anesthesia, while group O received intravenous ondansetron (8 mg) added to the usual saline solution. The control group (group C) received only intravenous fluid before spinal anesthesia and intrathecal bupivacaine without fentanyl. Shivering occurrences were observed and recorded during the procedure.Key results: The incidence of shivering was significantly lower in the fentanyl and ondansetron groups compared to the control group (p=0.0123). Both intrathecal fentanyl and intravenous ondansetron administration showed effectiveness in reducing shivering during spinal anesthesia. Conclusion:The administration of intrathecal fentanyl and intravenous ondansetron significantly reduced the occurrence of shivering during spinal anesthesia in cesarean section patients. This study contributes to advancing knowledge in the field by providing evidence of the preventative effects of these medications on post-spinal anesthesia shivering.

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“…In obstetrical anesthesia, dexmedetomidine has been use safely during normal labor for sedation, cesarean delivery and shivering prevention, with a low incidence of fetal distress due to high placental retention. 11 Dexmedetomidine has a low molecular weight, but high protein binding; therefore, transferring this drug through breastmilk is limited. Yoshimura et al 12 concluded that perinatal maternal use of dexmedetomidine is unlikely to be harmful to breastfeeding infants.…”

Section: Discussionmentioning

confidence: 99%

Tet Spells in a Parturient Woman with Uncorrected Tetaratolgy of Fallots Undergoing Cesarean Delivery

Lertkovit

Nivatpumin

2020

J Health Sci Med Res

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Tetralogy of Fallot (TOF) is the most common, cyanotic congenital heart disease. The hemodynamic changes during pregnancy, with uncorrected TOF, result in serious, life-threatening complications for both patient and baby. The authors report on the successful anesthetic management of a 26-year-old parturient women. The patient was at a gestational age of 33 weeks, with uncorrected TOF. After undergoing a cesarean delivery, she developed intraoperative hypoxia after delivery. We postulated that the patient developed hypoxic Tet spells from hypovolemia, resulting from postpartum bleeding as well as a decrease in her systemic vascular resistance from oxytocin. A multidisciplinary team approach and invasive intraoperative monitoring together with meticulous anesthetic management, were essential for this patient.

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Dexmedetomidine for every Cesarean delivery…maybe not?

Cited by 7 publications

References 23 publications

The Anesthetic Effect and Safety of Dexmedetomidine in Cesarean Section: A Meta-Analysis

The Anesthetic Effect and Safety of Dexmedetomidine in Cesarean Section: A Meta-Analysis

Fentanyl Versus Ondansetron for Shivering Prevention in Cesarean Section: A Comparative Study

Tet Spells in a Parturient Woman with Uncorrected Tetaratolgy of Fallots Undergoing Cesarean Delivery

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