Anästhesie und klinische Forschung
Offener Zugang

Abstrakt

Study of the Effect of Dexmedetomidine in Reducing Hemodynamic Responses to General Anesthesia for Elective Cesarean Section in Patients with Preeclampsia

Rabab Saber Saleh ElSayed Mahrous

Background: Depending on the effect of dexmedetomidine in haemodynamic stability, it was started to be used as a sedative prior to and/or during surgical and other procedures in non-intubated adult and pediatric patients. In 2009, dexmedetomidine has been successfully used in laboring parturients. It provides maternal hemodynamic stability, anxiolysis, and stimulation of uterine contractions. Literature describes that dexmedetomidine has a high placental retention and does not cross the placenta, with less incidence of fetal bradycardia. We hypothesized that dexmamedetomidine would be effective in reducing the maternal hemodynamic responses to elective cesarean section in preeclmaptic patients without adverse neonatal effects.

Methods: The series of the present study included forty parturients with preeclampsia who were planned for elective caesarean delivery for different indications under general anesthesia. The patients were divided in 2 groups and they were selected randomly to receive either fentanyl (control group), or 0.4 μg/kg/h intravenous dexmedetomidine 10 min before induction (n=20 per group). Changes in maternal heart rate, mean blood pressure, time from induction to delivery, the full anesthesia time, uterine contraction after placental delivery, umbilical blood gas parameters and Sedation scores were recorded.

Results: The heart rate in the dexmedetomidine group was lower than that in fentanyl group, patients in dexamedetomidine group had statistically significant lower change in mean arterial blood pressure, while patients taken fentanyl showed much higher mean arterial blood pressure from the induction till 5 minutes after extubation, Also the dexamedetomidine group showed greater uterine contraction, while there was no difference between both groups in Apgar score at 1 and 5 minute, NACS<35 and the umbilical blood gas analysis.

Conclusion: It could be concluded that, this study suggests the effective use of dexmedetomidine in preeclamptic patients undergoing elective cesarean as it stabilizes the maternal hemodynamic parameters with negligible effect on the fetus.