Dexmedetomidine as an intrathecal adjuvant for subarachnoid block for women undergoing elective cesarean section: An integrative review
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Aims and Objectives: This integrative review aims to evaluate the safety and effectiveness of intrathecal dexmedetomidine as an adjunct to hyperbaric bupivacaine for elective cesarean sections using subarachnoid block (SAB).
Methods: A review of the literature was performed on the following databases: PubMed, CINAHL Complete, Google Scholar, and Cochrane Collection. Relevant research articles were critically evaluated and added to a literature matrix for synthesis.
Results: Intrathecal dexmedetomidine-5 mcg enhances the efficacy of intrathecal bupivacaine 0.75% by 24% in women undergoing elective cesarian sections using SAB. Intrathecal bupivacaine administered with 5 mcg dexmedetomidine produced a similar analgesic effect as intrathecal morphine 100 mcg, with less pruritus and shivering. Dexmedetomidine also provides similar SAB characteristics compared to opioids. Dexmedetomidine increases block onset time, duration of the block, and time to first pain medication post-operatively.
Conclusion: Dexmedetomidine is a safe and effective local anesthetic (LA) adjuvant for SAB for elective Cesarian sections. It has not been shown to increase adverse patient outcomes such as nausea/vomiting, bradycardia, decreased APGAR score, and hypotension compared to other LA adjuvants. Using intrathecal dexmedetomidine instead of opioids decreases the incidence of shivering and pruritus.
Type | DNP Capstone Project |
Acquisition | Proxy-submission |
Review Type | Faculty Approved: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Other |
Research Approach | Translational Research/Evidence-based Practice |
Keywords | Intrathecal Dexmedetomidine; Subarachnoid Blockade; Cesarean Section; Intrathecal Opioids; Local Anesthetic Adjuvants |
Grantor | Bryan College of Health Sciences |
Advisor | Tritt, Matt |
Level | Doctoral-Other |
Year | 2022 |
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