The hemodynamic and analgesic profile of dexmedetomidine against fentanyl in preeclamptic parturients undergoing Cesarean section under general anesthesia

Abstract

Objective The aim of the study was to evaluate the effect of dexmedetomidine against fentanyl infusions on stabilizing intraoperative and postoperative hemodynamic parameters; the study also aimed to detect the effect of dexmedetomidine on postoperative pain and analgesic requirements and the neonatal outcome in preeclamptic parturients undergoing Cesarean section under general anesthesia. Patients and methods The study was conducted on 100 female preeclamptic parturients scheduled for elective Cesarean section under general anesthesia in the Kasr Elainy school of medicine. Patients were allocated randomly into two groups: group F, fentanyl group ( n = 50); group D, dexmedetomidine group ( n = 50). During surgery, the blood pressure and the heart rate were traced, and the ventilation time, the extubation time, the postoperative visual analogue score, the time for the first analgesic, the total analgesic requirements, postoperative nausea and vomiting, maternal satisfaction, and the neonatal outcome for each group were observed and recorded. Results Regarding hemodynamic parameters, the mean arterial blood pressure and the heart rate were significantly lower in group D in comparison with group F. There was a significant difference between the two study groups in the neurologic adaptive capacity score in favor of group D. Group D showed significantly longer spontaneous ventilation and extubation times compared with group F. The visual analogue score was significantly lower in group D than in group F at all times. Maternal satisfaction was higher in group D than in group F. Both study groups were comparable with regard to the quality of extubation and maternal complications. Conclusion The present study demonstrates the benefits of dexmedetomidine in augmenting the hemodynamic stability and the analgesic quality in preeclamptic patients undergoing Cesarean section under general anesthesia without any apparent deleterious maternal or fetal effects. This favors the use of dexmedetomidine as an adjuvant to general anesthesia in preeclamptic parturients in the future.