Effect of different doses of epidural dexmedetomidine on reducing visceral traction reaction for cesarean section: a double-blind randomized controlled trial

作者全名："Liu, Minghao; Wang, Bin; Prudence, Bizimana; Chen, Xuezi"

作者地址："[Liu, Minghao; Wang, Bin; Prudence, Bizimana; Chen, Xuezi] Chongqing Med Univ, Affiliated Hosp 1, Dept Anesthesiol, 1 Youyi Rd, Chongqing, Peoples R China"

通信作者："Wang, B (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Anesthesiol, 1 Youyi Rd, Chongqing, Peoples R China."

来源：JOURNAL OF ANESTHESIA

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000919569400001

JCR分区：Q2

影响因子：2.8

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Cesarean section; Dexmedetomidine; Epidural anesthesia; Visceral pain; Nullipara

摘要："PurposeThis study aimed to evaluate the effect of different doses of epidural dexmedetomidine on reducing visceral traction reaction for cesarean section under epidural anesthesia.MethodsNulliparas were randomly allocated to receive epidural ropivacaine alone (group R) or in combination with dexmedetomidine 0.5 mu g/kg (group RD0.5), 0.75 mu g/kg (group RD0.75), and 1 mu g/kg (group RD1) with 46 nulliparas in each group. The primary outcome was intraoperative visceral traction reaction (graded from 0 to 3, with 0 and 3, respectively, regarded as 'no discomfort in stomach or perineum; no nausea, vomiting or intestinal tympanites' and 'serious visceral pain, nausea and vomiting, intestinal tympanites').ResultsVisceral traction reaction was significantly alleviated in group RD0.5, RD0.75, and RD1, respectively, compared to group R while it was comparable among RD groups. Increased Ramsay Sedation Scale and lower incidence of shivering were found in RD groups compared to group R (p < 0.001). None of the primipara has experienced Ramsay Sedation Scale above 4. Higher incidence of thirst was found in group RD0.75 and RD1 compared to group R and RD0.5 (p < 0.001). The Apgar scores at 1 and 5 min of the neonates, onset time to T6 sensory block, maximum sensory block level, the incidence of hypotension, bradycardia and nausea or vomiting were comparable among groups.ConclusionIt is suggested that 0.5 mu g/kg epidural dexmedetomidine can be used as adjuvant to epidural ropivacaine during cesarean section, because of its alleviating visceral traction reaction, moderate sedating, and reducing shivering without thirst increase."

基金机构："Funding Chongqing Science and Technology Bureau [cstc2018jscx-msybx002]; Chongqing Health Bureau [2018GDRC009, 2018 jstg011, 2019jstg003, 2021jstg045]"

基金资助正文："This work was supported by Funding Chongqing Science and Technology Bureau (cstc2018jscx-msybx002) and Chongqing Health Bureau (2018GDRC009, 2018 jstg011, 2019jstg003, 2021jstg045)."