Dexmedetomidine infusion during caesarean section under general anaesthesia: Evaluation of maternal awareness using BIS, maternal and neonatal outcomes

Abstract

Study objectives: The present study investigated the effect of dexmedetomidine infusion on bispectral index and hemodynamic values for patients undergoing cesarean section under general anesthesia as well as the postoperative maternal and fetal outcomes. Design and setting: This is randomized controlled study done in operating rooms and postoperative recovery area. Patients: 44 Adult healthy pregnant females scheduled for elective Caesarian section delivery under general anesthesia were divided randomly in to two equal groups. Dexmedetomidine group and control group. Interventions: Unlike control group, Dexmedetomidine group: patients were given intravenous loading dose of DEX 1 mcg/kg before induction of anesthesia then intravenous infusion of DEX 0.4 mcg kg −1 hr −1 throughout surgery. Measurements: The BIS values; heart rate, blood pressure and MAC were monitored at 15 designated points of sequential events during anesthesia. The maternal sedation in the first postoperative hour was reported every 15 min. Apgar score of the neonates was assessed by the pediatrician 1 min and 5 min interval. All patients were asked about awareness or recall at the time of discharge and 6 h after. Results: BIS values, blood pressure, heart rate and MAC were significantly lower in DEX group at most different time intervals. Both groups of the study were matched as regard as Apgar score at 1 min. and 5 min. Alderete score was significantly lower in DEX group 15 min after extubation. However, both groups were matched 30 min after extubation. Sedation score was higher in Dex group at 5 and 15 min postoperatively. 10 patients in the control group needed extra dose of fentanyl. Conclusions: Dexmedetomidine is useful adjuvant during general anesthesia for CS as it attenuates hemodynamic responses to surgical stress, reduces needs for analgesic and anesthetic drugs together with favorable maternal and neonatal outcome.

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

“…Additionally, dexmedetomidine is a useful adjuvant during general anesthesia for cesarean deliveries, as it attenuates the hemodynamic response to surgical stress and reduces the need for analgesic and anesthetic drugs. 13 Hence, it was suitable for our patient.…”

Intraoperative Awareness During Cesarean Delivery Under General Anesthesia

“…The diagnosis of AGA based on symptoms related to sympathetic activation, such as hemodynamic parameters and objective signs such as lacrimation, sweat-ing, and movement, is not reliable enough and differs from monitoring such as electroencephalogram (EEG) changes [31], IFT [32], or BIS [33]. In such studies, which are designed based on patients' statements, the time of the interview is important, and in the long period after surgery, the possibility of forgetting the details should be considered.…”

Intraoperative Awareness in Patients Undergoing Cardiac Surgery in an Academic Center in the North of Iran

“…As mentioned, studies have reported contradictory results, which are justified by methodological differences, including inclusion criteria, studied populations, the time and the assessment tools, and the chosen type and dosage of anesthetics (22,23). Certainly, the detection of AGA based on sympathetic systems activation symptoms such as lacrimation, sweating, tachycardia, and increased blood pressure is not as reliable as IFT (24), electroencephalogram (EEG) changes (25), or BIS (24,26). In studies planned based on a direct interview, the questioning time is a determining factor.…”