Sufentanil vs. Dexmedetomidine as Neuraxial Adjuvants in Cesarean Section: A Mono-Centric Retrospective Comparative Study

Abstract

Spinal anesthesia is the best choice for caesarean delivery. This technique is characterized by a complete and predictable nerve block with a fast onset and few complications. Several intrathecal adjuvants are used in order to improve the quality and duration of anesthesia and reduce its side effects. Sixty-two patients who underwent caesarean delivery under spinal anesthesia were included in this medical records review. In this retrospective study, after adopting exclusion criteria, we assessed 24 patients who received Hyperbaric Bupivacaine 0.5% 10 mg and dexmedetomidine 10 μg (G1), and 28 patients who received an institutional standard treatment with Hyperbaric Bupivacaine 0.5% 10 mg and sufentanil 5 μg (G2). We evaluated the difference in terms of motor and sensory block, postoperative pain, and adverse effects during the first 24 h following delivery and neonatal outcome. Our study found that the sufentanil group had a significantly lower requirement for analgesia than the dexmedetomidine group. Postoperative pain, assessed with the VAS scale, was stronger in G1 than in G2 (4 ± 2 vs. 2 ± 1, p-value < 0.01). Differences between the two groups regarding the intraoperative degree of motor and sensory block, motor recovery time, and neonatal Apgar scores were not noticed. Pruritus and shivering were observed only in G2. Itching and shivering did not occur in the dexmedetomidine group. Postoperative analgesia was superior in the sufentanil group, but the incidence of side effects was higher. Adjuvant dexmedetomidine prevented postoperative shivering.

Impact of Ultrasound–Assisted Method on Success Rate of Spinal Anesthesia Performed by Novice Trainees: A Retrospective Comparative Study

“…This study aimed to validate the safety and efficacy of the educational possibilities of US-guided spinal anesthesia versus the LG technique, performed by novice trainees in patients with a difficult spine approach (such as patients with scoliosis, spinal deformities, and obesity), as often occurs in an orthopedic setting. So far, only a few studies have investigated different methods for teaching regional anesthesia to novice trainees, assessing the rate of success or comparing the discomfort, performing time, and complications between Ultrasound-Assisted spinal anesthesia and Landmark-Guided spinal anesthesia [24][25][26][27][28]. In this study, we analyzed the effects of diagnostic US imaging on success rates of spinal anesthesia and the risk of procedural complications.…”

“…Correct identification of interspinous space and the orientation of the immediately adjacent spinous process is essential for successful spinal anesthesia as it minimizes the number of attempts and the pain caused by multiple punctures, reducing the risk of spinal hematoma and post-dural puncture headache, and reducing the incidence of radicular pain, paresthesia, and patient discomfort [1,28,29]. Our results showed that the success rate of trainees in correctly identifying the subarachnoid space on their first attempt in orthopedic patients using the UA technique was 57.1%, unlike other studies that have shown a success rate of 88.4% [30]; the lower rate of h risk factors for anatomic distortion in the population of the other studies could explain the different result [30].…”

Dexamethasone versus Dexmedetomidine as Adjuvants in Ultrasound Popliteal Sciatic Nerve Block for Hallux Valgus Surgery: A Mono-Centric Retrospective Comparative Study

“… 12 These combinations have been found to be effective and safe for many types of patients, including pregnant women undergoing caesarean section. 13 More specifically, a few studies showed that dexamethasone used as adjuvant prolongs the duration of pain relief after minor foot and ankle surgery. 14 On the other side, dexmedetomidine used in peripheral nerve blocks seems to reduce the onset time, prolong the sensory and motor blocks and provide a sedative effect.…”

Efficacy of dexmedetomidine in the prevention and treatment of postanesthetic shivering after cesarean section

“…Shivering is observed in over 57% of pregnant women undergoing cesarean section, and its occurrence follows a seasonal pattern in which it is observed predominantly in autumn and winter [1,2]. Studies have shown that shivering in pregnant women after a cesarean section may lead to increased intraocular and intracranial pressure, subjective feeling of severe discomfort, reduced quality of life, and increased carbon dioxide production due to anaerobic respiration [3]. If not treated in time, these changes may result in severe acidosis and gradual reduction in resistance to infection, which are unfavorable for full postoperative recovery [4].…”