Effect of dexmedetomidine combined with sufentanil for post-caesarean section intravenous analgesia: A randomised, placebo-controlled study

    loading  Checking for direct PDF access through Ovid


BACKGROUNDFew studies have investigated the use of dexmedetomidine in obstetric anaesthesia.OBJECTIVETo evaluate the effect of dexmedetomidine combined with sufentanil for patient-controlled analgesia (PCA) after caesarean section under spinal anaesthesia.DESIGNAn interventional, randomised, double-blinded, placebo-controlled clinical study.SETTINGDepartment of Anaesthesiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.PATIENTSOne 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).INTERVENTIONSGroup 1: physiological saline bolus after delivery and sufentanil PCA, Group 2: dexmedetomidine bolus (0.5 μg kg−1) after delivery and sufentanil PCA, Group 3: dexmedetomidine bolus (0.5 μg kg−1) after delivery and sufentanil with dexmedetomidine PCA (background infusion of 0.045 μg kg−1 h−1 with a bolus of 0.07 μg kg−1).MAIN OUTCOME MEASURESThe 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.RESULTSSufentanil 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).CONCLUSIONThe combination of sufentanil and dexmedetomidine for PCA after caesarean section can reduce sufentanil consumption and improve parturients’ satisfaction compared with sufentanil PCA alone.TRIAL REGISTRATIONChiCTR-TRC-11001442.

    loading  Loading Related Articles