Dexmedetomidine improves intraoperative conditions and quality of postoperative analgesia when added to epidural in elective cesarean section

Abstract

IntroductionThis study was designed to evaluate the effect of adding dexmedetomidine to regular mixture of epidural drugs for pregnant women undergoing elective caesarian section with special emphasis on their sedative properties, ability to improve quality of intraoperative, postoperative analgesia and neonatal outcome.MethodsFifty women of ASA physical status I or II at term pregnancy were enrolled randomly to receive either plain bupivacaine plus fentanyl (BF group) or plain bupivacaine plus mixture of fentanyl and dexmedetomidine (DBF group). Incidence of hypotension, bradycardia, Apgar scores, intraoperative pain assessment, onset of postoperative pain, sedation scores and side effects were recorded.ResultsNo difference in the times taken for block to reach T4 sensory level, to reach the highest level of sensory block and interval between first neuraxial injection and onset of surgery between the groups. Onset of postoperative pain was significantly delayed in the DBF group (P = 0.001), the need for supplementary fentanyl was significantly less in DBF group (P = 0.03), and no significant difference was obtained between both groups regarding neonatal Apgar scores as well as the incidence of hypotension, bradycardia, nausea, vomiting and duration of motor blockade between the groups. DBF group had significantly less incidence of shivering (P = 0.03).ConclusionAdding dexmedetomidine to regular mixture of epidural anesthetics in women undergoing elective cesarean section improved intraoperative conditions and quality of postoperative analgesia without maternal or neonatal significant side effects.