Application of epidural use of compound solution of Dexmedetomidine and Ropivacaine on patients undergoing repeated cesarean section
WU Xia1YU Li1JIANG Xiu-hong1HE Ming-feng2▲
1.Department of Anesthesiology,Women and Children Health Care Hospital of Jiangsu Province,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210036,China;
2.Department of Anesthesiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
Abstract：ObjectiveTo observe the effect of epidural use of Dexmedetomidine and Ropivacaine on patients undergoing repeated cesarean section.MethodsA total of 40 parturient,treated in Jiangsu Women and Children Health Care Hospital from December 2015 to December 2016,scheduled for repeated cesarean section under epidural anesthesia were selected randomly.According to the random number table method,the patients were divided into group D and group R,with 20 patients in each group.0.75%Ropivacaine 15 ml was administered epidurally,with addition of 0.5 μg/kg of Dexmedetomidine in group D,and 2 ml of normal saline in group R.Mean arterial pressure(MAP),heart rate(HR)before anesthesia (T0),at 10 min after administration of the specific drugs (T1),at 30 min after administration of the specific drugs(T2),and end of surgery (T3)were recorded.The onset time of epidural sensory block,maximum sensory analgesic level,the time to maximum sensory analgesic level,the time of sensory block were collected.The modified Bromage scale,Ramsay grade and grade of traction reaction at T2,cases who used remifentanil,incidence of respiration inhibition and shiver were also assessed.Blood from umbilical veins was collected for blood gas analysis.The Apgar scores were evaluated at 1 and 5 min.ResultsThere was no significant difference in the MAP and HR at T0,T1,T2and T3between the two groups(P＞0.05).The onset time of epidural sensory block and the time to maximum sensory analgesic level in group D was shorter than that in group R,and the time of sensory block in group D was longer than that of group R,with significant difference (P＜0.05).The degree of sedative satisfaction in group D was higher than that in group R,the effect of traction reaction in the operation in group D was less than that of group R,and the proportion of the use of Remifentanil in group D was lower than that of group R,and the incidence of respiratory inhibition in group D was lower than that in group R,with significant difference (P＜0.05).The score of Apgar at 1 min after birth in group D was higher than that in group R,with significant difference(P＜0.05).ConclusionFor patients undergoing repeated cesarean section,epidural use of Dexmedetomidine combined with Ropivacaine can enhance the anesthetic effect,without obvious adverse maternal or neonatal effects.
Li C，Li Y，Wang K，et al.Comparative evaluation of remifentanil and dexmedetomidine in general anesthesia for cesarean delivery[J].Med Sci Monit，2015，7（21）：3806-3813.
[2]
Sun Y，Xu Y，Wang GN.Comparative evaluation of intrathecalbupivacainealone，bupivacaine-fentanyl，andbupivacainedexmedetomidine in caesarean section[J].Drug Res（Stuttg），2015，65（9）：468-472.
[3]
Noskova P，Blaha J，Bakhouche H，et al.Neonatal effect of remifentanil in general anaesthesia for caesarean section：a randomized trial[J].BMC Anesthesiol，2015，26（15）：38.
[4]
Stourac P，Kosinova M，Harazim H，et al.The analgesic efficacy of remifentanil for labour.Systematic review of the recent literature[J].Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub，2016，160（1）：30-38.
[5]
Yu M，Han C，Jiang X，et al.Effect and placental transfer of dexmedetomidine during caesarean section under general anaesthesia[J].Basic Clin Pharmacol Toxicol，2015，117（3）：204-208.
[6]
El-Tahan MR，Mowafi HA，Al Sheikh IH，et al.Efficacy of dexmedetomidine in suppressing cardiovascular and hormonal responses to general anaesthesia for caesarean delivery： a dose-response study[J].Int J Obstet Anesth，2012，21（3）：222-229.
[7]
Toyama H，Wagatsuma T，Ejima Y，et al.Cesarean section and primary pulmonary hypertension：the role of intravenous dexmedetomidine[J].Int J Obstet Anesth，2009，18（3）：262-267.
Karhade SS，Acharya SA，Harnagale K.Comparative analysis of epidural bupivacaine versus bupivacaine with dexmedetomidine for vaginal hysterectomy[J].Anesth Essays Res，2015，9（3）：310-313.
[10]
Afonso J，Reis F.Dexmedetomidine：current role in anesthesia and intensive care[J].Rev Bras Anestesiol，2012，62（1）：118-133.
[11]
Yousef AA，Salem HA，Moustafa MZ.Effect of mini-dose epidural dexmedetomidine in elective cesarean section using combined spinal-epidural anesthesia：a randomized double-blinded controlled study[J].J Anesth，2015，29（5）：708-714.
[12]
Bajwa SJ，Bajwa SK，Kaur J，et al.Dexmedetomidine and clonidine in epidural anaesthesia：a comparative evaluation[J].Indian J Anaesth，2011，55（2）：116-121.
[13]
James LS，Weisbrot IM，Prince CE，et al.The acid-base status of human infants in relation to birth asphyxia and the onset of respiration[J].J Pediatr，1958，52（4）：379-394.
[14]
Bajwa SJ，Gupta S，Kaur J，et al.Reduction in the incidence of shivering with perioperative dexmedetomidine：a randomized prospective study[J].J Anaesthesiol Clin Pharmacol，2012，28（1）：86-91.
[15]
Liu ZX，Xu FY，Liang X，et al.Efficacy of dexmedetomidine on postoperative shivering：a meta-analysis of clinical trials[J].Can J Anaesth，2015，62（7）：816-829.
京公网安备 11010502046607号