07 December 2015 : Clinical Research
Comparative Evaluation of Remifentanil and Dexmedetomidine in General Anesthesia for Cesarean Delivery
Chengwen LiABCDEF, Yandong LiABCDEF, Kun WangABEF, Xiangang KongABEFDOI: 10.12659/MSM.895209
Med Sci Monit 2015; 21:3806-3813
Abstract
BACKGROUND: Use of remifentanil and dexmedetomidine in general anesthesia for cesarean section have been described. This study was designed to evaluate the effects of remifentanil and dexmedetomidine on maternal hemodynamics and bispectral index, and neonatal outcomes in elective caesarean delivery.
MATERIAL AND METHODS: Forty-four women undergoing elective cesarean delivery with ASA I or II and term or near-term singleton pregnancies were randomly assigned to receive remifentanil at a loading dose of 2 μg/kg over 10 min followed by a continuous infusion of 2 μg/kg/h until about 6 min before fetal delivery (Group REM), or dexmedetomidine at a loading dose of 0.4 μg/kg over 10 min followed by a continuous infusion of 0.4 μg/kg/h until about 6 min before fetal delivery (Group DEX). Maternal hemodynamics and BIS values were recorded. Neonatal effects were assessed using Apgar scores and umbilical cord blood gas analysis.
RESULTS: Mean arterial pressure (MAP) increased after intubation in both groups, and the change magnitude of the MAP was higher in Group DEX (P<0.05). Patients in Group DEX had a lower BIS value at recovery and consumed less propofol during surgery (P<0.05). The incidences of neonatal resuscitation at 1 min were 81.8% in Group REM and 54.5% in Group DEX (P=0.052). There was no significant difference in either group in Apgar scores at 1 and 5 min and umbilical cord blood gas values.
CONCLUSIONS: Both remifentanil and dexmedetomidine are effective to blunt hemodynamic responses to intubation and also seem safe for neonates at the administrated doses, but remifentanil still has the potential to cause neonatal transient respiratory depression.
Keywords: Anesthetics, Intravenous - administration & dosage, Anesthesia, General, Apgar Score, Blood Pressure, Cesarean Section, Dexmedetomidine - administration & dosage, Heart Rate, Hypnotics and Sedatives - administration & dosage, Infant, Newborn, Piperidines - administration & dosage, Pregnancy
1368 14
Editorial
01 December 2023 : Editorial
Editorial: Outbreaks of Post-Pandemic Childhood Pneumonia and the Re-Emergence of Endemic Respiratory InfectionsDOI: 10.12659/MSM.943312
Med Sci Monit 2023; 29:e943312
In Press
08 Dec 2023 : Clinical Research
Association Between Influenza Vaccine Uptake and Health Awareness: A Cross-Sectional Questionnaire-Based St...Med Sci Monit In Press; DOI:
04 Dec 2023 : Animal Research
Effects of Intrathecal Ketamine on Cerebrospinal Fluid Levels of Brain-Derived Neurotrophic Factor and Mech...Med Sci Monit In Press; DOI:
01 Dec 2023 : Clinical Research
Risk Factors and Clinical Outcomes of COVID-19 Infection in Multiple Sclerosis Patients: A Retrospective St...Med Sci Monit In Press; DOI:
30 Nov 2023 : Review article
Decoding the Neurological Sequelae of General Anesthesia: A ReviewMed Sci Monit In Press; DOI:
Most Viewed Current Articles
13 Nov 2021 : Clinical Research
Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...DOI :10.12659/MSM.932788
Med Sci Monit 2021; 27:e932788
30 Dec 2021 : Clinical Research
Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...DOI :10.12659/MSM.935379
Med Sci Monit 2021; 27:e935379
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
08 Mar 2022 : Review article
A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...DOI :10.12659/MSM.936292
Med Sci Monit 2022; 28:e936292