Efficacy of dexmedetomidine in suppressing cardiovascular and hormonal responses to general anaesthesia for caesarean delivery: a dose–response study

El-Tahan, Mohamed R.; Mowafi, Hany A.; Sheikh, I.H. Al; Khidr, Alaa M; Al-Juhaiman, R.A.

doi:10.1016/j.ijoa.2012.04.006

Cited by 53 publications

(59 citation statements)

References 39 publications

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“…Dexmedetomidine was associated with a significant decrease in the perioperative serum level of cortisol, epinephrine and norepinephrine (Adeyemi, Vernon, & Medge, ). El‐Tahan reported a significant reduction in plasma concentrations of norepinephrine after administration of dexmedetomidine (El‐Tahan, Mowafi, Al Sheikh, Khidr, & Al‐Juhaiman, ).…”

Section: Discussionmentioning

confidence: 99%

Intrathecal dexmedetomidine versus magnesium sulphate for postoperative analgesia and stress response after caesarean delivery; randomized controlled double‐blind study

Mostafa

Herdan

Fathy

et al. 2019

European Journal of Pain

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Background Various adjuvants were added to intrathecal anaesthetics to improve quality of the block and postoperative analgesia. We hypothesized that intrathecal dexmedetomidine and magnesium sulphate (MgSO4) may add similar effects. Our objectives were to compare their effects as adjuvants to intrathecal bupivacaine on postoperative analgesia, stress hormones, sedative properties and the neonatal outcome after caesarean section. Methods A randomized double‐blind controlled study; 90 parturients were divided into three groups. All patients received intrathecal hyperbaric bupivacaine 12.5 mg. NaCl 0.9% was added to intrathecal block in group C, 5 μg dexmedetomidine in the group D and 50 mg MgSO4 in group M. Visual analogue scale (VAS) score, stress hormones were assessed within the first 12 postoperative hours, sensory block, and neonatal outcome were also assessed. Results VAS scores were significantly lower in groups D and M. Onset of postoperative pain was significantly prolonged in group D. Time to peak sensory level was shorter in group D. Sedation score was significantly higher in group D only after 30 min of intrathecal block. Although stress hormones increased in all groups during intraoperative and postoperative periods, their levels were significantly lower in group D compared to other groups. No differences were noted regarding neonatal outcomes. Conclusion Intrathecal dexmedetomidine is superior to intrathecal MgSO4 during caesarean section with regard to duration of analgesia, pain severity and stress hormone levels. Dexmedetomidine has a rapid onset and longer duration of sensory block compared to MgSO4. No significant adverse effects to the parturients or newborns.

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Section: Discussionmentioning

confidence: 99%

Intrathecal dexmedetomidine versus magnesium sulphate for postoperative analgesia and stress response after caesarean delivery; randomized controlled double‐blind study

Mostafa

Herdan

Fathy

et al. 2019

European Journal of Pain

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“…5 Although there are many studies in the literature reporting the use of dexmedetomidine to reduce the perioperative use of opioids, [6][7][8][9] only a few have studied the use of dexmedetomidine in parturients. 10 This prospective, randomised, double-blind, controlled study was designed to investigate whether the administration of dexmedetomidine immediately after delivery and for PCA can decrease postoperative sufentanil consumption and pain intensity after surgery. We also wished to explore the effect of dexmedetomidine on pain threshold (PTh) and pain tolerance threshold (PTTh) of parturients who undergo caesarean section.…”

Section: Introductionmentioning

confidence: 99%

Effect of dexmedetomidine combined with sufentanil for post-caesarean section intravenous analgesia

Nie

Liu²,

Luo³

et al. 2014

European Journal of Anaesthesiology

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“…This is in agreement with earlier studies. 12,13 However the incidence of sedation in the mother is significantly more in the dexmedetomidine group. No special treatment was required for it.…”

Section: Discussionmentioning

confidence: 95%

Evaluation of intrathecal bupivacaine alone, bupivacaine with butorphanol and bupivacaine with dexmedetomidine for lower segment caesarean section: a randomized control trial

Meitei

Rubina

Laithangbam

et al. 2016

Int J Basic Clin Pharmacol

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INTRODUCTIONThe need for early ambulation for caring of the neonate by mother makes postoperative pain management after caesarean delivery unique. To achieve this, various drug combinations and techniques have been tried to find out the more effective and safer analgesia. Most breast feeding women may choose to limit their systemic analgesic doses. Neuroaxial analgesic technique are gold standards for pain relief during labour and delivery.1 The intrathecal opioids have been used to increase the duration of postoperative analgesia without affecting the sympathetic and motor functions. Opioids with µ-receptor agonists like fentanyl, buprenorphine, etc. have been tried extensively for this purpose. However, side effects due to µ-receptor stimulation like respiratory depression, pruritus, urinary retention and abuse liability remain a concern.To alleviate this problem alpha agonist like clonidine have been used alone or in combination with opioids for lower abdominal surgery and labour analgesia.3-6 Despite increasing the duration of postoperative analgesia, alpha2 agonist also causes side effects like sedation, dryness of mouth and hypotension specially in higher dose. Dexmedetomidine is another highly selective alpha2 agonist which has been used in surgical patients ABSTRACT Background: Following caesarean operation, a painless early ambulation is necessary to mother for caring of the neonate. Aim of the study is to compare more effective analgesic by intrathecal bupivacaine or combination with butorphanol or dexmedetomidine. Methods: Ninety parturients undergoing elective caesarean section were randomly divided into three equal groups (n=30). Group B: received bupivacaine (0.5%) 2 ml + 0.5 ml of normal saline (NS); group BB, bupivacaine (0.5%) 2 ml + 25 mcg butorphanol in 0.5 ml NS and group BD, bupivacaine (0.5%) 2ml + 2.5 mcg of dexmedetomidine in 0.5 ml NS . Visual numerical rating scale (VNRS), heart rate, blood pressure, sensory and motor block levels, fetal outcome by Apgar score and umbilical cord blood pH, any side effects were noted. Results: The onset time of modified Bromage 3 motor block was statistically significant among the groups (P=0.023) but not significant between Groups BB and BD (P=0.479). The regression time to reach modified Bromage 0 in group BD was significantly longer (P=<0.0001) than either of the groups B or BB but not significant between the later two groups (P=0.479). Time for 2-segment regression, sensory regression time to S1 dermatome and time for first rescue analgesia were significantly longer (P<0.001) in group BD but not significant between the groups B and BB. Sedation was significantly more in group BD (17/30 pts; P<0.001). Conclusions: Addition of dexmedetomidine to spinal bupivacaine block in caesarean section increase the duration of analgesia and motor block with minimal side effect and no adverse effects on the babies.

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Efficacy of dexmedetomidine in suppressing cardiovascular and hormonal responses to general anaesthesia for caesarean delivery: a dose–response study

Cited by 53 publications

References 39 publications

Intrathecal dexmedetomidine versus magnesium sulphate for postoperative analgesia and stress response after caesarean delivery; randomized controlled double‐blind study

Intrathecal dexmedetomidine versus magnesium sulphate for postoperative analgesia and stress response after caesarean delivery; randomized controlled double‐blind study

Effect of dexmedetomidine combined with sufentanil for post-caesarean section intravenous analgesia

Evaluation of intrathecal bupivacaine alone, bupivacaine with butorphanol and bupivacaine with dexmedetomidine for lower segment caesarean section: a randomized control trial

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