Effect of Different Doses of Intrathecal Dexmedetomidine as an Adjuvant Combined With Hyperbaric Ropivacaine in Patients Undergoing Cesarean Section

Abstract

In this study, we aim to investigate the effect of different doses of dexmedetomidine as an adjuvant to hyperbaric ropivacaine in spinal anesthesia for cesarean section. Methods: Seventy-five parturients with American Society of Anesthesiologists (ASA) I or II were anesthetized with intrathecal ropivacaine (12.5 mg) alone (R group) or in combination with dexmedetomidine 3 mg (RD3 group) and 5 mg (RD5 group) to undergo a cesarean section. The anesthetic parameters, postoperative analgesia, stress responses and neonates outcomes were monitored. Results: The onset time of sensory block to T10, T4, and peak level in the RD3 group and RD5 group were significantly shorter than those in the R group (p < 0.05). The time of the level of sensory block to descend two segments and to T10 in the RD3 group(57.28 ± 16.65 min, 3.87 ± 1.60 h) and RD5 group (71.92 ± 10.10 min, 3.99 ± 1.06 h) were longer than that in the R group (40.64 ± 12.06 min, 1.98 ± 1.01 h) (p < 0.05). The median time of motor blockade to both legs score 3 on the Bromage scale (B3B3) in the RD3 group and RD5 group was shorter than that in the R group (p < 0.001). The time of motor blockade recovery to both legs score 0 on the Bromage scale (B0B0) in the RD5 group (3.6 h) was longer than that in the R group (2 h) or RD3 group (2.2 h) (p < 0.001). Visceral traction response and abdominal muscle relaxation during the operation in the RD3 group and the RD5 group were better than that in the R group. The Visual Analogue Score (VAS) in the 12 h after the operation in the RD3 group (3.30 ± 1.17) and RD5 group (2.80 ± 0.87) was smaller than that in the R group (3.80 ± 1.47) (p < 0.05). The incidence of shivering in the RD3 group and RD5 group was significantly lower than that in the R group (p < 0.05). The postoperative concentrations of c-reactive protein (CRP), interleukin-6 (IL-6) and cortisol in the RD3 and RD5 groups were lower than that in the R group (p < 0.05). Conclusion: 3 µg intrathecal dexmedetomidine as an adjuvant to ropivacaine improved intraoperative somato-visceral sensory block characteristics and postoperative analgesia,

Successful Treatment of Refractory Cancer Pain and Depression with Continuous Intrathecal Administration of Dexmedetomidine and Morphine: A Case Report

“…We observed no side effects from the addition of DEX in this particular patient. These results are consistent with previous research demonstrating that patients did not report DEX-related side effects while receiving it intrathecally as an adjuvant pain therapy [ 18 , 25 ]. Table 1 records the overall side effects experienced by this patient.…”

No Difference between Spinal Anesthesia with Hyperbaric Ropivacaine and Intravenous Dexmedetomidine Sedation with and without Intrathecal Fentanyl: A Randomized Noninferiority Trial

“…Various intrathecal adjuvants, such as opioids and α -2 agonists (clonidine and dexmedetomidine), can be administered along with ropivacaine [ 24 , 25 ]. In a previous study, intrathecal dexmedetomidine demonstrated prolonged duration of sensory block with minimal side effects [ 24 , 26 ]. It can also be administered intravenously for sedation during spinal anesthesia and has gained popularity due to the prolonged action of the block and patient satisfaction [ 12 , 14 ].…”

PROSPECT guideline for elective caesarean section: updated systematic review and procedure‐specific postoperative pain management recommendations

“…However, both intrathecal morphine and intrathecal dexmedetomidine provided better analgesia when compared with isobaric bupivacaine (53). Administration of intrathecal dexmedetomidine resulted in improved postoperative analgesia when compared with isobaric bupivacaine or ropivacaine alone [54,55]. Intrathecal dexmedetomidine combined with intrathecal magnesium sulphate or intrathecal morphine improved analgesia which was of longer duration than analgesia produced by magnesium sulphate alone [56,57].…”