Intraoperative conditions and quality of postoperative analgesia after adding dexmedetomidine to epidural bupivacaine and fentanyl in elective cesarean section using combined spinal-epidural anesthesia

Hanoura, Samy; Hassanin, Rabei; Singh, Rajvir

doi:10.4103/0259-1162.118947

Cited by 31 publications

(32 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Moreover, shivering, nausea and vomiting were also less in the dexmedetomidine group compared with the morphine group, consistent with other studies. [25][26][27][28] The low incidence of shivering might reflect a decreased shivering threshold and a lower core temperature.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Intrathecal Dexmedetomidine with Morphine as Adjuvants in Cesarean Sections

Chen

et al. 2016

Biological & Pharmaceutical Bulletin

View full text Add to dashboard Cite

To compare the effects of intrathecal dexmedetomidine and intrathecal morphine as supplements to bupivacaine in cesarean sections under spinal anesthesia. Full-term parturients (n 120) undergoing elective cesarean sections under spinal anesthesia were randomly allocated into three groups: Group B received 10 mg bupivacaine, Group BD received 10 mg bupivacaine plus 5 µg dexmedetomidine, and Group BM received 10 mg bupivacaine plus 100 µg morphine. The onset and regression time of sensory and motor blockade, postoperative analgesia, and side effects were recorded. Group BD showed quicker onset time and a longer sensory and motor blockade than other groups (BD vs. B and BD vs. BM, p<0.05). The mean time of sensory regression to the S1 segment was 253.21 42.79 min in group BD, 192.50 40.62 min in group BM and 188.33 37.62 min in group B (p<0.001). Group BD showed an analgesia duration (time to requirement of first rescue analgesic) (17.59 6.23 h) similar to that of group BM (16.78 5.90 h) but longer than that of group B (3.53 1.68 h) (p<0.001). The incidence of pruritus was significantly higher in group BM compared with groups BD and B (p<0.001). Less shivering was observed in group BD than in groups BM and B ( p 0.009). So intrathecal dexmedetomidine (5 µg) prolonged the motor and sensory blockade, provided a similar analgesic effect and reduced pruritus and shivering compared with morphine (100 µg) in cesarean sections.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of Intrathecal Dexmedetomidine with Morphine as Adjuvants in Cesarean Sections

Chen

et al. 2016

Biological & Pharmaceutical Bulletin

View full text Add to dashboard Cite

show abstract

“…17,18,19 Onset of postoperative pain was significantly early in the group A than group B or group C, with the need for supplementary analgesic in group A. 20 The cardiovascular stability was better in group A and B than group C. Eight patients had bradycardia and six patients had hypotension in group C which was treated with atropine and phenylephrine respectively. A study ZA Zang et al, 21 with low dose epidural dexmeditomidinem i.e.…”

Section: Discussionmentioning

confidence: 96%

Effect of Diffe Rent Concentrations of Epidural D E Xmeditomidine for Post - Operative Analgesia

Raghupatruni¹,

Ganesh²

2015

jemds

View full text Add to dashboard Cite

BACKGROUND:The aim of our study was to know the ideal epidural dose to achieve analgesia in the postoperative patients using different concentrations of epidural dexmeditomidine. METHODS AND MATERIALS: Ninety patients of either sex, with age ranging from 25 years to 60 years were randomly selected and divided into three groups of thirty each. Group A received epidural 0.25% bupivacaine along with 25mcg of dexmeditomidine, Group B received epidural 0.25% bupivacaine along with 50mcg dexmeditomidine and Group C received epidural 0.25% bupivacaine along with 75 mcg dexmeditomidine. The duration of analgesia, sedation and cardiovascular stability were studied. RESULTS: Analgesia and sedation was more in Group C than the other two groups. Cardiovascular stability was good in groups A and B.

show abstract

“…But it can produce side effects like bradycardia and hypotension in some patients. [9] Ketamine a (NMDA antagonist)can cause hypertension and tachycardia when used intravenously. [10] We have compared epidural ketamine with dexmedetomidine to study the efficacy in prolonging the duration of analgesia and found that duration of analgesia was prolonged in group RD compared to group RK which was also supported by few other studies.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Randomized Double Blind Study on Efficacy of Dexmedetomidine and Ketamine as Adjuvant to Epidural Ropivacaine in Lower Abdominal and Lower Limb Surgery

Das¹,

Pradhan²,

Debata³

2017

AIMDR

View full text Add to dashboard Cite

Background: Various adjuvants including α-2 adrenergic agonist have been used to prolong the action of local anaesthetics in epidural anaesthesia. Now a days dexmedetomidine is most commonly used adjuvant in epidural anaesthesia but still it may produce side effects like hypotension and bradycardia.There is limited study on efficacy of ketamine as adjuvant in epidural anaesthesia. Aim: The aim of the study was to compare the duration of postoperative analgesia and side effects of epidural dexmedetomidine with ropivacaine versus epidural ketamine with ropivacaine in lower abdominal and lower limb surgery. Methods: This prospective randomised study was carried out in 100 patients of 20-60 years of age and of ASA classes I/II. All the patients, posted for lower abdominal and lower limb surgery were divided into two groups of 50 each. Group RD received 15ml ropivacaine(0.75%) with dexmedetomidine(1µgm/kg) and group RK received 15ml ropivacaine with ketamine(0.5mg/kg).Time for first rescue analgesia request, sensory and motor block characteristics and side effects were recorded. p<0.05 was considered statistically significant. Results: Time of first rescue analgesia request was delayed in group RD (360.15±35.23min) than group RK (311.14±32.48min) which was statistically significant. Both onset of sensory and motor block was earlier and duration of sensory and motor block was prolonged in group RD compared to group RK which was statistically significant. Hemodynamic parameters and side effects were comparable in both groups. Conclusion: Dexmedetomidine is a superior additive to ropivacaine compared to ketamine. Dexmedetomidine provides prolonged postoperative analgesia, earlier onset of sensory and motor block with minimal side effects.

show abstract

Intraoperative conditions and quality of postoperative analgesia after adding dexmedetomidine to epidural bupivacaine and fentanyl in elective cesarean section using combined spinal-epidural anesthesia

Cited by 31 publications

References 32 publications

Comparison of Intrathecal Dexmedetomidine with Morphine as Adjuvants in Cesarean Sections

Comparison of Intrathecal Dexmedetomidine with Morphine as Adjuvants in Cesarean Sections

Effect of Diffe Rent Concentrations of Epidural D E Xmeditomidine for Post - Operative Analgesia

A Prospective Randomized Double Blind Study on Efficacy of Dexmedetomidine and Ketamine as Adjuvant to Epidural Ropivacaine in Lower Abdominal and Lower Limb Surgery

Contact Info

Product

Resources

About