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ORIGINAL ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 1  |  Page : 23-28

Effect of intrathecal dexmedetomidine on the quality of combined spinal epidural analgesia and obstetric outcome during vaginal delivery


1 Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University Hospitals, Zagazig University, Zagazig, Egypt
2 Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University Hospitals, Zagazig University, Zagazig, Egypt

Correspondence Address:
Heba M Fathi
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University Hospitals, Zagazig University, Zagazig, 44519
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2356-9115.202696

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Introduction A prospective double-blind randomized controlled study was conducted to evaluate the efficacy and safety of intrathecal (IT) dexmedetomidine when used combined spinal epidural analgesia on maternal and neonatal outcomes during vaginal delivery. Patients and methods A total of 60 patients were randomly divided into two groups: group B comprised 30 patients who received IT 2.5 mg hyperbaric bupivacaine+0.05 ml normal saline and group D comprised 30 patients who received IT 2.5 mg hyperbaric bupivacaine+0.05 ml (5 µg) dexmedetomidine. Epidural catheter was inserted in both groups. Epidural analgesia of 10–12 ml of 0.125% bupivacaine in repeated doses was given when visual analog scale (VAS) greater than 3 until delivery. If emergency Cesarean section was indicated, epidural 10–15 ml of 0.5% bupivacaine was administered. The characters of analgesia, VAS, progress of labor, maternal side effects, and neonatal outcomes in terms of mode of delivery and neonatal Apgar score and umbilical artery pH were recorded. Results There was a significant shorter onset, longer duration of analgesia and lower number of patients who requested epidural analgesia in group D than in group B. VAS was lower in group D from 10 min until 4 h after spinal injection. Duration of second stage and number of instrumental deliveries was lower in group D. There were no maternal or neonatal complications in both groups, but first Apgar score was higher in group D (P<0.05). Conclusion The addition of IT dexmedetomidine to combined spinal epidural improves the quality of analgesia and is considered safe during vaginal delivery.


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