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Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Effect of different doses of epidural dexmedetomidine on reducing visceral traction reaction for cesarean section: a double-blind randomized controlled trial.
Journal of Anesthesia 2023 June
PURPOSE: This study aimed to evaluate the effect of different doses of epidural dexmedetomidine on reducing visceral traction reaction for cesarean section under epidural anesthesia.
METHODS: Nulliparas were randomly allocated to receive epidural ropivacaine alone (group R) or in combination with dexmedetomidine 0.5 μg/kg (group RD0.5), 0.75 μg/kg (group RD0.75), and 1 μg/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').
RESULTS: Visceral 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.
CONCLUSION: It is suggested that 0.5 μg/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.
METHODS: Nulliparas were randomly allocated to receive epidural ropivacaine alone (group R) or in combination with dexmedetomidine 0.5 μg/kg (group RD0.5), 0.75 μg/kg (group RD0.75), and 1 μg/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').
RESULTS: Visceral 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.
CONCLUSION: It is suggested that 0.5 μg/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.
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