Περίληψη:
Background: Dexmedetomidine, a highly selective alpha(2) agonist has
been studied in the past for its use as adjuvant to local anesthetics
for spinal anesthesia. Fentanyl has also been used as a spinally
administered adjuvant to various local anesthetics. The aim of this
study was to investigate the duration of motor and sensory block along
with the hemodynamic parameters, neonatal Apgar scores, postoperative
analgesia and maternal satisfaction of overall anesthetic/analgesic
regimen in parturients under ropivacaine 0.75% plus dexmedetomidine or
fentanyl spinal anesthesia. Methods: Forty patients American Society Of
Anesthesiology (ASA) I or II, scheduled for elective cesarean section
were studied. Patients were randomly allocated to receive ropivacaine
0.75% 1.6-2 mL plus 10 mu g fentanyl (Group F, n = 20) or ropivacaine
0.75% 1.6-2 mL plus 10 mu g dexmedetomidine (Group D, n = 20),
intrathecally. The primary outcome was duration of motor and sensory
block. Secondary outcomes were:neonatal Apgar scores in the first and
fifth minute, additional postoperative analgesia, time to first
postoperative analgesic dose and maternal satisfaction of overall
anesthesia and analgesia. Results: Patients in dexmedetomidine group
(Group D) had prolonged duration of motor and sensory block when
compared to patients in fentanyl group (Group F). Mean duration of motor
block was significantly higher in Group D than in Group F (163.75 min
versus 124.75 min respectively, p = 0.013). Regression of the sensory
block to T-8 was significantly prolonged for Group D (158.50 min Group D
versus 114.25 min in Group F, p = 0.021). Neonatal Apgar scores,
additional postoperative analgesia, time to first postoperative
analgesic dose and maternal satisfaction of overall anesthesia/analgesia
process, did not statistically differ between the groups. Conclusions:
Intrathecal dexmedetomidine is associated with prolonged motor and
sensory block. Its profile is similar to fentanyl in terms of
cardiovascular stability, sedation, Apgar scores, patient satisfaction
and postoperative analgesia.
Συγγραφείς:
Tsaroucha, Athanasia
Grigoriadou, Aliki Tympa
Moshovou, Tania
and Theodoraki, Kassiani
Melemeni, Aikaterini
