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Intravenous Dexmedetomidine as an Adjunct to Neuraxial Anesthesia in Cesarean Delivery: A Retrospective Chart Review

BACKGROUND: Dexmedetomidine is a selective α-2 agonist commonly used for sedation that has been used in obstetric anesthesia for multimodal labor analgesia, postcesarean delivery analgesia, and perioperative shivering. This study evaluated the role of intravenous dexmedetomidine to provide rescue an...

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Autores principales: Davis, Paul R., Sviggum, Hans P., Delaney, Daniel J., Arendt, Katherine W., Jacob, Adam K., Sharpe, Emily E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8723858/
https://www.ncbi.nlm.nih.gov/pubmed/34987573
http://dx.doi.org/10.1155/2021/9887825
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author Davis, Paul R.
Sviggum, Hans P.
Delaney, Daniel J.
Arendt, Katherine W.
Jacob, Adam K.
Sharpe, Emily E.
author_facet Davis, Paul R.
Sviggum, Hans P.
Delaney, Daniel J.
Arendt, Katherine W.
Jacob, Adam K.
Sharpe, Emily E.
author_sort Davis, Paul R.
collection PubMed
description BACKGROUND: Dexmedetomidine is a selective α-2 agonist commonly used for sedation that has been used in obstetric anesthesia for multimodal labor analgesia, postcesarean delivery analgesia, and perioperative shivering. This study evaluated the role of intravenous dexmedetomidine to provide rescue analgesia and/or sedation during cesarean delivery under neuraxial anesthesia. METHODS: We conducted a single-center, retrospective cohort study of all parturients undergoing cesarean delivery under neuraxial anesthesia between December 1, 2018, and November 30, 2019, who required supplemental analgesia during the procedure. Patients were divided into two groups: patients who received intravenous dexmedetomidine (Dexmed group) and patients who received adjunct medications such as fentanyl, midazolam, ketamine, and nitrous oxide (Standard group). Primary outcome was incidence of conversion to general anesthesia. RESULTS: During the study period, 107 patients received adjunct medications. There was no difference in conversion to general anesthesia between the Dexmed group and the Standard group (6% (4/62) vs. 9% (4/45); p=0.718). In the Dexmed group, the mean dexmedetomidine dose received was 37 μg (range 10 to 140 μg). While the use of inotropic/vasopressor medications was common and similar in both groups, there was an increase in the incidence of bradycardia (Dexmed 15% vs. Standard 2%; p=0.042) but not hypotension (Dexmed 24% vs. Standard 24%; p=1.00) in the Dexmed group. CONCLUSION: In patients who required supplemental analgesia for cesarean delivery, those who received dexmedetomidine versus other medications had a similar rate of conversion to general anesthesia, a statistically significant increase in bradycardia, but no difference in the incidence of hypotension.
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spelling pubmed-87238582022-01-04 Intravenous Dexmedetomidine as an Adjunct to Neuraxial Anesthesia in Cesarean Delivery: A Retrospective Chart Review Davis, Paul R. Sviggum, Hans P. Delaney, Daniel J. Arendt, Katherine W. Jacob, Adam K. Sharpe, Emily E. Anesthesiol Res Pract Research Article BACKGROUND: Dexmedetomidine is a selective α-2 agonist commonly used for sedation that has been used in obstetric anesthesia for multimodal labor analgesia, postcesarean delivery analgesia, and perioperative shivering. This study evaluated the role of intravenous dexmedetomidine to provide rescue analgesia and/or sedation during cesarean delivery under neuraxial anesthesia. METHODS: We conducted a single-center, retrospective cohort study of all parturients undergoing cesarean delivery under neuraxial anesthesia between December 1, 2018, and November 30, 2019, who required supplemental analgesia during the procedure. Patients were divided into two groups: patients who received intravenous dexmedetomidine (Dexmed group) and patients who received adjunct medications such as fentanyl, midazolam, ketamine, and nitrous oxide (Standard group). Primary outcome was incidence of conversion to general anesthesia. RESULTS: During the study period, 107 patients received adjunct medications. There was no difference in conversion to general anesthesia between the Dexmed group and the Standard group (6% (4/62) vs. 9% (4/45); p=0.718). In the Dexmed group, the mean dexmedetomidine dose received was 37 μg (range 10 to 140 μg). While the use of inotropic/vasopressor medications was common and similar in both groups, there was an increase in the incidence of bradycardia (Dexmed 15% vs. Standard 2%; p=0.042) but not hypotension (Dexmed 24% vs. Standard 24%; p=1.00) in the Dexmed group. CONCLUSION: In patients who required supplemental analgesia for cesarean delivery, those who received dexmedetomidine versus other medications had a similar rate of conversion to general anesthesia, a statistically significant increase in bradycardia, but no difference in the incidence of hypotension. Hindawi 2021-12-27 /pmc/articles/PMC8723858/ /pubmed/34987573 http://dx.doi.org/10.1155/2021/9887825 Text en Copyright © 2021 Paul R. Davis et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Davis, Paul R.
Sviggum, Hans P.
Delaney, Daniel J.
Arendt, Katherine W.
Jacob, Adam K.
Sharpe, Emily E.
Intravenous Dexmedetomidine as an Adjunct to Neuraxial Anesthesia in Cesarean Delivery: A Retrospective Chart Review
title Intravenous Dexmedetomidine as an Adjunct to Neuraxial Anesthesia in Cesarean Delivery: A Retrospective Chart Review
title_full Intravenous Dexmedetomidine as an Adjunct to Neuraxial Anesthesia in Cesarean Delivery: A Retrospective Chart Review
title_fullStr Intravenous Dexmedetomidine as an Adjunct to Neuraxial Anesthesia in Cesarean Delivery: A Retrospective Chart Review
title_full_unstemmed Intravenous Dexmedetomidine as an Adjunct to Neuraxial Anesthesia in Cesarean Delivery: A Retrospective Chart Review
title_short Intravenous Dexmedetomidine as an Adjunct to Neuraxial Anesthesia in Cesarean Delivery: A Retrospective Chart Review
title_sort intravenous dexmedetomidine as an adjunct to neuraxial anesthesia in cesarean delivery: a retrospective chart review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8723858/
https://www.ncbi.nlm.nih.gov/pubmed/34987573
http://dx.doi.org/10.1155/2021/9887825
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