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Effect of dexmedetomidine combined with sufentanil for post-caesarean section intravenous analgesia: a randomised, placebo-controlled study.
Eur J Anaesthesiol. 2014 Apr; 31(4):197-203.EJ

Abstract

BACKGROUND

Few studies have investigated the use of dexmedetomidine in obstetric anaesthesia.

OBJECTIVE

To evaluate the effect of dexmedetomidine combined with sufentanil for patient-controlled analgesia (PCA) after caesarean section under spinal anaesthesia.

DESIGN

An interventional, randomised, double-blinded, placebo-controlled clinical study.

SETTING

Department of Anaesthesiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

PATIENTS

One hundred and twenty parturients (American Society of Anesthesiologists class 1 or 2) scheduled for elective caesarean delivery under spinal anaesthesia randomly allocated into three groups (n = 40 each).

INTERVENTIONS

Group 1: physiological saline bolus after delivery and sufentanil PCA, Group 2: dexmedetomidine bolus (0.5 μg kg) after delivery and sufentanil PCA, Group 3: dexmedetomidine bolus (0.5 μg kg) after delivery and sufentanil with dexmedetomidine PCA (background infusion of 0.045 μg kg h with a bolus of 0.07 μg kg).

MAIN OUTCOME MEASURES

The total consumption of sufentanil. Pain scores at rest evaluated with a visual analogue scale (VAS) and Ramsay sedation score (RSS) were recorded at the 4, 8 and 24 h after surgery. The patients' pain threshold (PTh) and pain tolerance threshold (PTTh) were measured before surgery and 1 h after initial study drug administration. Satisfaction scores were collected 24 h after surgery.

RESULTS

Sufentanil consumption in group 3 was 43.9 ± 19.2 μg, significantly lower than in group 1 (54.5 ± 23.9 μg) and group 2 (56.3 ± 20.6 μg) (P < 0.05). Compared with group 3, VAS was increased at 4, 8 and 24 h after surgery in groups 1 and 2 (P < 0.05); there was no difference between groups 1 and 2. PTh and PTTh were significantly increased 1 h after drug administration in groups 2 (1.59 ± 0.45, 2.57 ± 0.46 mA) and 3 (1.74 ± 0.37, 2.56 ± 0.48 mA) compared with group 1 (1.49 ± 0.49, 2.42 ± 0.62 mA) (P < 0.05).

CONCLUSION

The combination of sufentanil and dexmedetomidine for PCA after caesarean section can reduce sufentanil consumption and improve parturients' satisfaction compared with sufentanil PCA alone.

TRIAL REGISTRATION

ChiCTR-TRC-11001442.

Authors+Show Affiliations

From the Department of Anesthesiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

24463478

Citation

Nie, Yuyan, et al. "Effect of Dexmedetomidine Combined With Sufentanil for Post-caesarean Section Intravenous Analgesia: a Randomised, Placebo-controlled Study." European Journal of Anaesthesiology, vol. 31, no. 4, 2014, pp. 197-203.
Nie Y, Liu Y, Luo Q, et al. Effect of dexmedetomidine combined with sufentanil for post-caesarean section intravenous analgesia: a randomised, placebo-controlled study. Eur J Anaesthesiol. 2014;31(4):197-203.
Nie, Y., Liu, Y., Luo, Q., & Huang, S. (2014). Effect of dexmedetomidine combined with sufentanil for post-caesarean section intravenous analgesia: a randomised, placebo-controlled study. European Journal of Anaesthesiology, 31(4), 197-203. https://doi.org/10.1097/EJA.0000000000000011
Nie Y, et al. Effect of Dexmedetomidine Combined With Sufentanil for Post-caesarean Section Intravenous Analgesia: a Randomised, Placebo-controlled Study. Eur J Anaesthesiol. 2014;31(4):197-203. PubMed PMID: 24463478.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of dexmedetomidine combined with sufentanil for post-caesarean section intravenous analgesia: a randomised, placebo-controlled study. AU - Nie,Yuyan, AU - Liu,Yuqi, AU - Luo,Qingyan, AU - Huang,Shaoqiang, PY - 2014/1/28/entrez PY - 2014/1/28/pubmed PY - 2014/11/7/medline SP - 197 EP - 203 JF - European journal of anaesthesiology JO - Eur J Anaesthesiol VL - 31 IS - 4 N2 - BACKGROUND: Few studies have investigated the use of dexmedetomidine in obstetric anaesthesia. OBJECTIVE: To evaluate the effect of dexmedetomidine combined with sufentanil for patient-controlled analgesia (PCA) after caesarean section under spinal anaesthesia. DESIGN: An interventional, randomised, double-blinded, placebo-controlled clinical study. SETTING: Department of Anaesthesiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. PATIENTS: One hundred and twenty parturients (American Society of Anesthesiologists class 1 or 2) scheduled for elective caesarean delivery under spinal anaesthesia randomly allocated into three groups (n = 40 each). INTERVENTIONS: Group 1: physiological saline bolus after delivery and sufentanil PCA, Group 2: dexmedetomidine bolus (0.5 μg kg) after delivery and sufentanil PCA, Group 3: dexmedetomidine bolus (0.5 μg kg) after delivery and sufentanil with dexmedetomidine PCA (background infusion of 0.045 μg kg h with a bolus of 0.07 μg kg). MAIN OUTCOME MEASURES: The total consumption of sufentanil. Pain scores at rest evaluated with a visual analogue scale (VAS) and Ramsay sedation score (RSS) were recorded at the 4, 8 and 24 h after surgery. The patients' pain threshold (PTh) and pain tolerance threshold (PTTh) were measured before surgery and 1 h after initial study drug administration. Satisfaction scores were collected 24 h after surgery. RESULTS: Sufentanil consumption in group 3 was 43.9 ± 19.2 μg, significantly lower than in group 1 (54.5 ± 23.9 μg) and group 2 (56.3 ± 20.6 μg) (P < 0.05). Compared with group 3, VAS was increased at 4, 8 and 24 h after surgery in groups 1 and 2 (P < 0.05); there was no difference between groups 1 and 2. PTh and PTTh were significantly increased 1 h after drug administration in groups 2 (1.59 ± 0.45, 2.57 ± 0.46 mA) and 3 (1.74 ± 0.37, 2.56 ± 0.48 mA) compared with group 1 (1.49 ± 0.49, 2.42 ± 0.62 mA) (P < 0.05). CONCLUSION: The combination of sufentanil and dexmedetomidine for PCA after caesarean section can reduce sufentanil consumption and improve parturients' satisfaction compared with sufentanil PCA alone. TRIAL REGISTRATION: ChiCTR-TRC-11001442. SN - 1365-2346 UR - https://www.unboundmedicine.com/medline/citation/24463478/Effect_of_dexmedetomidine_combined_with_sufentanil_for_post_caesarean_section_intravenous_analgesia:_a_randomised_placebo_controlled_study_ DB - PRIME DP - Unbound Medicine ER -