Role of Dexmedetomidine in Obstetric Anaesthesia& Analgesia
O.M.Abdel-Maksoud, M.A.ELrabeae, D.H.Elbarbary, M.A.Said"
Dexmedetomidine is a highly selective Î±-2 adrenergic receptor agonist which when used in recommended dose in the form of an infusion has several desirable properties like sedation, anxiolysis, sympatholysis, analgesia, stimulation of uterine contractions, decreased intraoperative anaesthetic requirements. It was approved by United States Food and Drug Administration [US FDA] in 1999 for use in humans for short-term sedation and analgesia in Intensive Care Unit [ICU] for less than 24 hours. 140 female patients were divided into three groups, 40 patients were included in the first group Intravenous infusion of [dexmedetomidine versus pethidine in continuous intravenous infusion at the start of active labor at cervical dilatation 4 cm], 60 patients were included in the second group comparative study between Intrathecal [Dexmedetomidine+ Bupivacaine] versus [Fentanyl + Bupivacaine] versus [Bupivacaine] in LSCS, and 40 patients were included in the third group comparative study between intravenous dexmedetomidine infusions versus magnesium sulphate infusion in preeclampsia patients. Regarding to the first group there were significant difference between VAS of group Ia [4.80 Â± 0.62 ] compared to group Ib[5.75 Â± 1.07], and the second group there was highly significance between the groups IIa ,IIb &IIc regarding VAS as group IIa [3.75Â±1.16], group IIb [5.20 Â±1.32], group IIc [5.85 Â±1.84] there was highly significance regarding onset of motor block between these 3 groups As [ group IIa [ 6.675Â±1.18], group IIb [7.32Â±1.66],group IIc [9.12Â±1.58]], There was highly significance also between 3 groups regarding onset of sensory block As [group IIa [7.85Â±1.06],group IIb [8.70Â±1.62],group IIc [10.50Â±1.88],There was significance between 3 groups regarding sensory block duration As [ group IIa [189.43Â±84.39], group IIb [160.70Â±68.62], group IIc [116.73Â±48.60], and the third group there was significance regarding uterine contraction between group IIIa &group IIIb As group IIIa[2.50 Â± 0.69] group IIIb[1.60 Â±0.99], and there was significance between group IIIa &group IIIb regarding APGAR score as group IIIa [9.35 Â± 0.67] & group IIIb [8.25 Â± 1.21]. In conclusion deximetomidine is the best as multiuse drug for analgesia in normal labor by intravenous infusion & analgesia and Anaesthesia of cesarean section by intrathecal injection& analgesia and Anaesthesia for preeclampsia.
Dexmedetomidine, Obstetric Anaesthesia, Obstetric Analgesia.