Objective: To compare the efficacy of dexmedetomidine and midazolam in the prevention of postoperative nausea and vomiting (PONV) caused by hemabate in postpartum hemorrhage during cesarean delivery.
Methods: One hundred and five parturients with American Society of Anesthesiology (ASA) physical status I and II, aged 20– 40 years, undergoing elective cesarean delivery under epidural anesthesia were randomly allocated into dexmedetomidine group (group D, n=35), midazolam group (group M, n=35) and control group (group C, n=35). Patients received an intrauterine injection of 250 μg hemabate and continuous intravenous infusion of 5 units oxytocin immediately following the delivery of the infant. At the same time, patients in group D received 1μg/kg intravenous dexmedetomidine, group M received 0.02 mg/kg intravenous midazolam and group C received 20 mL intravenous saline. Parameters such as the PONV, other adverse reactions (chest distress, flush, etc.) caused by hemabate, patient satisfaction, the sedation (OAA/S) scores, and the hemodynamic parameters were recorded in both groups.
Results: The PONV incidence in group D and group M was significantly lower compared with group C (6%, 17%, and 71% for group D, group M, and group C, respectively, P< 0.05). The sedation (OAA/S) scores in group D and group M was significantly higher compared with group C (1.62± 0.28, 1.75± 0.31, and 1.00± 0.00 for group D, group M, and group C, respectively, P< 0.05). The patient satisfaction in group D and group M was significantly higher compared with group C (94%, 69%, and 46% for group D, group M, and group C, respectively, P< 0.05). Furthermore, there were more patients satisfied with group D than group M (94% vs.69%, P< 0.05).
Conclusion: Intravenous dexmedetomidine (1 μg/kg) and midazolam (0.02 mg/kg) were equally effective in preventing PONV introduced by hemabate and dexmedetomidine is superior to midazolam in patient satisfaction.

Keywords: dexmedetomidine, midazolam, PONV, hemabate, cesarean delivery


中文翻译：

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右美托咪定和咪达唑仑在预防剖宫产术中 Hemabate 引起的术后恶心和呕吐的比较：一项随机对照试验。

目的：比较右美托咪定和咪达唑仑预防剖宫产术中血红蛋白引起的术后恶心呕吐（PONV）的疗效。
方法：将 105 名美国麻醉学会（ASA）身体状况 I 级和 II 级的产妇，年龄 20 ～ 40 岁，在硬膜外麻醉下进行择期剖宫产，随机分为右美托咪定组（D 组，n=35）、咪达唑仑组（ M组，n=35)和对照组(C组，n=35)。患者在婴儿分娩后立即接受宫内注射 250 μg hemabate 和连续静脉输注 5 个单位的催产素。同时，D组患者给予右美托咪定1μg/kg静脉注射，M组给予咪达唑仑0.02mg/kg静脉注射，C组给予生理盐水20mL静脉注射。诸如 PONV、血红素引起的其他不良反应（胸闷、潮红等）、患者满意度、镇静（OAA/S）评分等参数，
结果： D组和M组的PONV发生率明显低于C组（D组、M组和C组分别为6%、17%和71%，P<0.05）。D组、M组镇静（OAA/S）评分显着高于C组（D组、M组、C组分别为1.62±0.28、1.75±0.31、1.00±0.00，P<0.05） ）。D组、M组患者满意度显着高于C组（D组、M组、C组分别为94%、69%、46%，P<0.05）。此外，对D组满意的患者多于M组（94% vs.69%，P<0.05）。
结论：静脉注射右美托咪定 (1 μg/kg) 和咪达唑仑 (0.02 mg/kg) 在预防由 hemabate 引入的 PONV 方面同样有效，并且在患者满意度方面，右美托咪定优于咪达唑仑。

关键词:右美托咪定, 咪达唑仑, PONV, hemabate, 剖宫产