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


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


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


METHODS
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).


METHODS
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).


METHODS
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).


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


BACKGROUND
ChiCTR-TRC-11001442.
From the Department of Anesthesiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Yuyan
Y
Nie
Yuqi
Y
Liu
Qingyan
Q
Luo
Shaoqiang
S
Huang
D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods; D018712:Analgesics, Non-Narcotic; D000775:Anesthesia, Spinal / Q000379:methods; D002585:Cesarean Section; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D017288:Pain Threshold; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D011247:Pregnancy; D011446:Prospective Studies; D017409:Sufentanil / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors
D018712:Analgesics, Non-Narcotic; D020927:Dexmedetomidine; D017409:Sufentanil