The use of neuraxial dexmedetomidine in the caesarean patient

Abstract

<p>In obstetric patients undergoing a cesarean section, does a spinal block combining dexmedetomidine and local anesthetic compared with just local anesthetic result in a change in the incidence of side effects, density, onset, or duration of the block during the first 120 minutes from insertion of the medication?</p> <p>The use of dexmedetomidine in spinal anesthesia has been well researched. Dexmedetomidine in the increments of 3,5, and 10 mcg has been shown to consistently reduce the onset time of the sensory and motor block of spinal anesthesia while also prolonging the duration of the sensory block significantly. Evidence shows that adding 5 mcg of dexmedetomidine can cause the duration of the sensory block to increase from 108 minutes to 148 minutes and the onset time of the sensory block to decrease from 3.4 minutes to 2.9 minutes. Dexmedetomidine has also been shown to reduce the amount of bupivacaine needed for an adequate sensory block by 24% when including 5 mcg of dexmedetomidine as an additive. The side effects of spinal anesthesia include shivering, pruritus, nausea, and hypotension. The addition of 5 mcg of dexmedetomidine has been shown to statistically reduce the incidence of shivering with no effect on the incidence of other side effects of a spinal block. Research concluded that there was no further benefit in increasing the dosage of dexmedetomidine from 5 mcg to 10 mcg, and 5 mcg was adequate to gain the benefits in onset time, efficacy, increased duration, and the reduction in the incidence of shivering. Dexmedetomidine also significantly increased the postoperative pain-free time from an average of 145 minutes to 230 minutes and decreased the amount of postoperative sufentanil needed from 65.9 mcg to 56.3 mcg.</p>