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ORIGINAL ARTICLE
Year : 2017  |  Volume : 45  |  Issue : 4  |  Page : 220-225

Dexmedetomidine in preeclamptic patients undergoing caesarean section under general anesthesia


Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt

Correspondence Address:
Nosaiba K Ezz El-Arab
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University, Botross street, El-Gharbia, Tanta
Egypt
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DOI: 10.4103/tmj.tmj_35_17

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Background Dexmedetomidine is used as a sedative in surgical and other procedures in nonintubated adult and pediatric patients. It has been successfully used in laboring parturients as it provides maternal hemodynamic stability and anxiolysis. Aim The aim of this study is to assess the effects of dexmedetomidine in preeclampsia patients under general anesthesia as regards: pressor response to laryngoscopy and intubation, doses of anesthetic agents, muscle relaxants and narcotics, uterine contractility and neonatal effect, postoperative recovery, and postoperative analgesic requirements. Patients and methods This study was carried out on 60 parturients with preeclampsia who were scheduled for elective caesarean delivery. Patients were divided randomly into two groups: DEX group, patients received 1 µg/kg intravenous dexmedetomidine 10 min before induction and a maintenance dose with 0.4 µg/kg/h during surgery, and the control group: patients did not receive dexmedetomidine (n=30/group). Changes in maternal heart rate, mean arterial blood pressure, time from induction to delivery, full anesthesia time (especially during stress of intubation), and depth of anesthesia were monitored by bispectral index. The total dose of propofol, rocuronium and fentanyl consumption, uterine contraction after placental delivery, Apgar score, postoperative recovery profile, postoperative pain, and postoperative analgesia were also assessed. Results Heart rate was significantly lower in the DEX group than in the control group. The mean arterial blood pressure was significantly lower in the DEX group than in the control group from the induction till after extubation. Also there was significant decrease in the total consumption of propofol, fentanyl, and muscle relaxant in the DEX group than in the control group, while both groups were comparable in uterine contraction, Apgar score, and awareness. Conclusion This study suggests the effective use of dexmedetomidine in pre-eclamptic patients undergoing elective cesarean as it stabilizes the maternal hemodynamic parameters during intubation and after intubation with negligible effect on the fetus.


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