Randomized Controlled Trial to Evaluate the Efficacy of Intrathecal Dexmedetomidine to Low dose hyperbaric 0.5% Bupivacaine in Elective Lower Segment Caesarean Section
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引用次数: 0
Abstract
Abstract
Introduction: Dexmedetomidine has been safely used as an adjuvant for subarachnoid block in obstetric as well as non-obstetric surgeries and was found to be effective without adverse effects. Hence, this study was conducted to determine the efficacy of intrathecal Dexmedetomidine for elective lower segment caesarean sections with reduction of local anesthetic dose.
Objectives: This double blinded, randomized controlled study was designed to compare the effects of addition of Dexmedetomidine on 1) Sensory and motor block 2) Maternal hemodynamics 3) Post-operative analgesia and 4) Neonatal outcome.
Methods: Eighty parturients were enrolled in study and randomized into two groups as of 40 each and named as Group D and Group B. Group D received 0.5% Hyperbaric Bupivacaine 9mg (1.8ml) + Dexmedetomidine 5µg (0.2ml of 25 µg per ml ) and for Group B received 0.5% Hyperbaric Bupivacaine 10mg (2ml) . Characteristics of block, maternal hemodynamics and neonatal outcome were recorded. P value <0.05 was considered as significant.
Results: Sensory onset was rapid in D group as compared to B group (3.7 ± 1.1vs 4.5±1.2) and motor onset was also rapid in D group (3.8±2.0 vs 4.9 ±1.9) with 95% CI. Duration of analgesia was also significantly high in Group D (230.5±40.5 vs 145.1±28.5). No adverse maternal and fetal outcomes were reported.
Conclusion: Intrathecal Dexmedetomidine with low dose bupivacaine for cesarean section hastens the sensory as well as motor onset without adversely affecting mother and neonate.
摘要简介:在产科和非产科手术中,右美托咪定已被安全地用作蛛网膜下腔阻滞的辅助药物,并且被发现是有效的,没有副作用。因此,本研究旨在确定鞘内注射右美托咪定在减少局部麻醉剂量的情况下对选择性下段剖腹产的疗效。目的:这项双盲随机对照研究旨在比较添加右美托咪定对1)感觉和运动阻滞2)母体血液动力学3)术后镇痛和4)新生儿结局的影响。方法:80名产妇被纳入研究,并随机分为两组,每组40人,分别命名为D组和B组。D组接受0.5%高压布比卡因9mg(1.8ml)+右美托咪定5µg(0.2ml,每ml 25µg),B组接受0.5%高压布比卡因10mg(2ml)。记录阻滞特征、母体血液动力学和新生儿结局。P值<0.05被认为是显著的。结果:与B组相比,D组的感觉发作迅速(3.7±1.1 vs 4.5±1.2),运动发作也迅速(3.8±2.0 vs 4.9±1.9),CI为95%。D组的镇痛持续时间也显著延长(230.5±40.5 vs 145.1±28.5)。没有不良的母体和胎儿结局报告。结论:鞘内注射右美托咪定和小剂量布比卡因用于剖宫产可加速感觉和运动发作,而不会对母亲和新生儿产生不利影响。