Efficacy of intrathecally administered fentanyl versus dexmedetomidine for cesarean section: a double blinded, randomized clinical trial
Background: Dexmedetomidine, a highly selective α2 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 durat...
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| Format: | Article |
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IMR Press
2021-10-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/48/5/10.31083/j.ceog4805171 |
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| author | Athanasia Tsaroucha Aliki Tympa Grigoriadou Tania Moshovou Kassiani Theodoraki Aikaterini Melemeni |
| author_facet | Athanasia Tsaroucha Aliki Tympa Grigoriadou Tania Moshovou Kassiani Theodoraki Aikaterini Melemeni |
| author_sort | Athanasia Tsaroucha |
| collection | DOAJ |
| description | Background: Dexmedetomidine, a highly selective α2 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 μg fentanyl (Group F, n = 20) or ropivacaine 0.75% 1.6–2 mL plus 10 μg 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 T8 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. |
| format | Article |
| id | doaj-art-49751cc1895e459ca66c0e785cd7b1cf |
| institution | Kabale University |
| issn | 0390-6663 |
| language | English |
| publishDate | 2021-10-01 |
| publisher | IMR Press |
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| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-49751cc1895e459ca66c0e785cd7b1cf2025-08-20T03:48:31ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632021-10-014851065107010.31083/j.ceog4805171S0390-6663(21)00010-5Efficacy of intrathecally administered fentanyl versus dexmedetomidine for cesarean section: a double blinded, randomized clinical trialAthanasia Tsaroucha0Aliki Tympa Grigoriadou1Tania Moshovou2Kassiani Theodoraki3Aikaterini Melemeni41st Department of Anesthesiology, Aretaieion Hospital, National and Kapodistrian University of Athens, 76 Vas.Sofias avenue, 11528 Athens, Greece1st Department of Anesthesiology, Aretaieion Hospital, National and Kapodistrian University of Athens, 76 Vas.Sofias avenue, 11528 Athens, Greece1st Department of Anesthesiology, Casa di Cura Città di Roma, 00152 Rome, Italy1st Department of Anesthesiology, Aretaieion Hospital, National and Kapodistrian University of Athens, 76 Vas.Sofias avenue, 11528 Athens, Greece1st Department of Anesthesiology, Aretaieion Hospital, National and Kapodistrian University of Athens, 76 Vas.Sofias avenue, 11528 Athens, GreeceBackground: Dexmedetomidine, a highly selective α2 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 μg fentanyl (Group F, n = 20) or ropivacaine 0.75% 1.6–2 mL plus 10 μg 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 T8 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.https://www.imrpress.com/journal/CEOG/48/5/10.31083/j.ceog4805171intrathecal dexmedetomidineelective cesarean sectionadjuvant |
| spellingShingle | Athanasia Tsaroucha Aliki Tympa Grigoriadou Tania Moshovou Kassiani Theodoraki Aikaterini Melemeni Efficacy of intrathecally administered fentanyl versus dexmedetomidine for cesarean section: a double blinded, randomized clinical trial Clinical and Experimental Obstetrics & Gynecology intrathecal dexmedetomidine elective cesarean section adjuvant |
| title | Efficacy of intrathecally administered fentanyl versus dexmedetomidine for cesarean section: a double blinded, randomized clinical trial |
| title_full | Efficacy of intrathecally administered fentanyl versus dexmedetomidine for cesarean section: a double blinded, randomized clinical trial |
| title_fullStr | Efficacy of intrathecally administered fentanyl versus dexmedetomidine for cesarean section: a double blinded, randomized clinical trial |
| title_full_unstemmed | Efficacy of intrathecally administered fentanyl versus dexmedetomidine for cesarean section: a double blinded, randomized clinical trial |
| title_short | Efficacy of intrathecally administered fentanyl versus dexmedetomidine for cesarean section: a double blinded, randomized clinical trial |
| title_sort | efficacy of intrathecally administered fentanyl versus dexmedetomidine for cesarean section a double blinded randomized clinical trial |
| topic | intrathecal dexmedetomidine elective cesarean section adjuvant |
| url | https://www.imrpress.com/journal/CEOG/48/5/10.31083/j.ceog4805171 |
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