Protective effect of dexmedetomidine on kidney injury of parturients with preeclampsia undergoing cesarean section: a randomized controlled study

Zhang, Qing lin; Wang, Lei; Xu, Ming jun; Wang, Tian Long

doi:10.1042/bsr20190352

Cited by 9 publications

(8 citation statements)

References 23 publications

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“…Previous studies have reported that administration of dexmedetomidine provided a significant hemodynamic stability during cesarean section in patients with preeclampsia [ 24 – 28 ]. There is very little published research on administration of dexmedetomidine for postoperative sedation of preeclampsia patients.…”

Section: Discussionmentioning

confidence: 99%

Effect of Dexmedetomidine on Cardiac Output among Parturient with Severe Preeclampsia after Cesarean Section

Zhou

Qiao

et al. 2022

Computational and Mathematical Methods in Medicine

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This study was to investigate the hemodynamic effect of dexmedetomidine among parturient with severe preeclampsia after cesarean section. Parturient with severe preeclampsia were randomly allocated to receive dexmedetomidine (0.2-0.7 μg/kg/h) or equivalent volumes of 0.9% saline as control after cesarean section, respectively. A total of 36 parturient with severe preeclampsia were enrolled, including 18 in the dexmedetomidine (DEX) group and 18 in the saline group. Compared with the saline group, among those in the DEX group, CO was reduced by 1.30 L/min (95% CI: -2.36 to 0.25; P = 0.019 ). Additionally, HR (-13.79 bpm, 95% CI: -22.02 to -5.58; P = 0.002 ), SBP (-16.11 mmHg, 95% CI: -30.56 to -1.66; P = 0.030 ), DBP (-10.48 mmHg, 95% CI: -18.27 to -2.69; P = 0.002 ), and MAP (-12.36 mmHg, 95% CI: -22.05 to -2.66; P = 0.014 ) were reduced in the DEX group compared with the saline group. In contrast, there were no changes observed in SV and ICON between groups. In conclusion, dexmedetomidine reduces cardiac output by inhibiting the acceleration of heart rate without sacrificing myocardial contractility and stroke volume.

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Section: Discussionmentioning

confidence: 99%

Effect of Dexmedetomidine on Cardiac Output among Parturient with Severe Preeclampsia after Cesarean Section

Zhou

Qiao

et al. 2022

Computational and Mathematical Methods in Medicine

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“…7,19 In addition, it has certain organ protective effects in subjects with preeclampsia, pulmonary hypertension in pregnancy and hyperthyroidism. [20][21][22][23] It is possible that these properties can be beneficial to the intraoperative and postoperative safety of caesarean delivery.…”

Section: Discussionmentioning

confidence: 99%

“…Dexmedetomidine can be administered both intravenously and intrathecally in obstetric anaesthesia 16–18 to optimize anaesthesia, reduce intraoperative stress and adverse reactions and ensure the safety of the infant and breastfeeding 7,19 . In addition, it has certain organ protective effects in subjects with preeclampsia, pulmonary hypertension in pregnancy and hyperthyroidism 20–23 . It is possible that these properties can be beneficial to the intraoperative and postoperative safety of caesarean delivery.…”

Section: Discussionmentioning

confidence: 99%

Effect of dexmedetomidine on oxytocin‐induced uterine contraction during optimal caesarean section anaesthesia

Zhang

et al. 2022

Basic Clin Pharma Tox

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Numerous drugs are used during caesarean sections to provide regional and general anaesthesia. Dexmedetomidine has been used in some recent obstetric trials, but there are concerns about postpartum changes in uterine contractions. This study evaluated the effect of dexmedetomidine on oxytocin-induced uterine contractions in women undergoing caesarean section. Sixty women undergoing caesarean section in Lianyungang Second People's Hospital were randomly assigned to dexmedetomidine (group D, n = 30) or saline (group C, n = 30) groups. Equal volumes of saline or dexmedetomidine were administered intravenously (IV). During the intraoperative delivery of the foetus and placenta, oxytocin was administered to promote contractions. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial

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“… 137 It is also reported that dexmedetomidine exerts protective effects on kidney injury of parturients with preeclampsia undergoing cesarean section. 138 An assessment of its effect on both the mothers and neonates during cesarean section under general anesthesia indicates that dexmedetomidine presents better neonatal Apgar scores, postoperative analgesia, and decreased catecholamine release. 139 Moreover, the use of dexmedetomidine in the perioperative period of cesarean section is not only conducive to the early conversion of infant feeding to exclusive breastfeeding but can also enhance the recovery quality and comfort of the parturient, optimize analgesia, reduce the time to the first lactation, and increase lactation.…”

Section: Key Surgical Applicationsmentioning

confidence: 99%

Recent Advances in the Clinical Value and Potential of Dexmedetomidine

Liu¹,

Li²,

Kang³

et al. 2021

JIR

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Dexmedetomidine, a highly selective α2-adrenoceptor agonist, has sedative, anxiolytic, analgesic, sympatholytic, and opioid-sparing properties and induces a unique sedative response which shows an easy transition from sleep to wakefulness, thus allowing a patient to be cooperative and communicative when stimulated. Recent studies indicate several emerging clinical applications via different routes. We review recent data on dexmedetomidine studies, particularly exploring the varying routes of administration, experimental implications, clinical effects, and comparative advantages over other drugs. A search was conducted on the PubMed and Web of Science libraries for recent studies using different combinations of the words “dexmedetomidine”, “route of administration”, and pharmacological effect. The current routes, pharmacological effects, and application categories of dexmedetomidine are presented. It functions by stimulating pre- and post-synaptic α2-adrenoreceptors within the central nervous system, leading to hyperpolarization of noradrenergic neurons, induction of an inhibitory feedback loop, and reduction of norepinephrine secretion, causing a sympatholytic effect, in addition to its anti-inflammation, sleep induction, bowel recovery, and sore throat reduction effects. Compared with similar α2-adrenoceptor agonists, dexmedetomidine has both pharmacodynamics advantage of a significantly greater α2:α1-adrenoceptor affinity ratio and a pharmacokinetic advantage of having a significantly shorter elimination half-life. In its clinical application, dexmedetomidine has been reported to present a significant number of benefits including safe sedation for various surgical interventions, improvement of intraoperative and postoperative analgesia, sedation for compromised airways without respiratory depression, nephroprotection and stability of hypotensive hemodynamics, reduction of postoperative nausea and vomiting and postoperative shivering incidence, and decrease of intraoperative blood loss. Although the clinical application of dexmedetomidine is promising, it is still limited and further research is required to enhance understanding of its pharmacological properties, patient selection, dosage, and adverse effects.

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Protective effect of dexmedetomidine on kidney injury of parturients with preeclampsia undergoing cesarean section: a randomized controlled study

Cited by 9 publications

References 23 publications

Effect of Dexmedetomidine on Cardiac Output among Parturient with Severe Preeclampsia after Cesarean Section

Effect of Dexmedetomidine on Cardiac Output among Parturient with Severe Preeclampsia after Cesarean Section

Effect of dexmedetomidine on oxytocin‐induced uterine contraction during optimal caesarean section anaesthesia

Recent Advances in the Clinical Value and Potential of Dexmedetomidine

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