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The Effectiveness and Safety of Intravenous Dexmedetomidine of Different Concentrations Combined with Butorphanol for Post-Caesarean Section Analgesia: A Randomized Controlled Trial
Drug Design, Development and Therapy ( IF 4.8 ) Pub Date : 2021-02-18 , DOI: 10.2147/dddt.s287512 Shijiang Liu 1 , Peipei Peng 1 , Youli Hu 1 , Cunming Liu 1 , Xiaofei Cao 1 , Chun Yang 1 , Mei Gao 1
Drug Design, Development and Therapy ( IF 4.8 ) Pub Date : 2021-02-18 , DOI: 10.2147/dddt.s287512 Shijiang Liu 1 , Peipei Peng 1 , Youli Hu 1 , Cunming Liu 1 , Xiaofei Cao 1 , Chun Yang 1 , Mei Gao 1
Affiliation
Purpose: The present study aimed to determine the effectiveness of intravenous dexmedetomidine of different concentrations and to evaluate its maternal and neonatal safety when combined with butorphanol in parturients undergoing cesarean section.
Patients and Methods: A total of 114 parturients between 24 and 43 years of age, with singleton pregnancy who underwent elective cesarean section under epidural anesthesia, were randomly allocated to four groups: group C received 0.9% sodium chloride after delivery, followed by butorphanol (3 μg·kg− 1·h− 1); patients in groups D1, D2, and D3 received 0.5 μg·kg− 1·h− 1 dexmedetomidine after delivery, followed by butorphanol (3 μg·kg− 1·h− 1) combined with dexmedetomidine 0.03, 0.05, and 0.08 μg·kg− 1·h− 1, respectively. The primary outcome was the visual analogue scale (VAS) score at 6 h after delivery when patients were at rest. Secondary outcome measures included VAS after delivery when patients were on movement and uterine cramping, Ramsay sedation scale (RSS), relative infant dose (RID) of dexmedetomidine, satisfaction with analgesia after surgery and symptoms of CNS depression in neonates.
Results: There were no significant differences in patient characteristics among the groups (P > 0.05). The VAS at all timepoints after delivery in groups D2 and D3 were significantly lower than in groups C and D1 (P < 0.001). RSS scores were clearly higher in group D3 than in the other three groups at 6 h and 12 h (P < 0.0001). RID in groups D1, D2, and D3 was 0.171%, 0.197%, and 0.370%, respectively. Compared with group D1, RID was higher in group D3 (P = 0.0079). Degree of satisfaction with analgesia was higher in groups D2 and D3 (P < 0.005).
Conclusion: Continuous intravenous infusion of 0.05 μg·kg− 1·h− 1 dexmedetomidine combined with 3 μg·kg− 1·h− 1 butorphanol could be safely applied in healthy parturients with satisfactory analgesia after cesarean section without changes in sedation.
Keywords: cesarean section, dexmedetomidine, analgesia, relative infant dose, anesthesia
中文翻译：
静脉注射不同浓度右美托咪定联合布托啡诺用于剖宫产术后镇痛的有效性和安全性：随机对照试验
目的：本研究旨在确定静脉注射不同浓度右美托咪定的有效性，并评估其与布托啡诺联合用于剖宫产产妇的母婴安全性。
患者与方法：将114例24~43岁的单胎妊娠产妇在硬膜外麻醉下择期剖宫产，随机分为4组：C组产后给予0.9%氯化钠，随后给予布托啡诺。 3 μg·kg - 1 ·h - 1 ); D1、D2、D3组患者分娩后给予0.5 μg·kg - 1 ·h - 1右美托咪定，随后给予布托啡诺（3 μg·kg - 1·h - 1 ) 分别与右美托咪定 0.03、0.05 和 0.08 μg·kg - 1 ·h - 1联合使用。主要结果是分娩后 6 小时患者休息时的视觉模拟评分 (VAS) 评分。次要结局指标包括分娩后患者运动和子宫痉挛时的 VAS、Ramsay 镇静量表 (RSS)、右美托咪定的婴儿相对剂量 (RID)、术后镇痛满意度和新生儿中枢神经系统抑制症状。
结果：各组患者特征差异无统计学意义（P > 0.05）。D2、D3组产后各时间点VAS均显着低于C、D1组（P< 0.001)。在 6 小时和 12 小时，D3 组的 RSS 评分明显高于其他三组（P < 0.0001）。D1、D2 和 D3 组的 RID 分别为 0.171%、0.197% 和 0.370%。与D1组相比，D3组RID较高（P =0.0079）。D2、D3组镇痛满意度较高（P <0.005）。
结论：健康产妇剖宫产术后连续静脉滴注0.05 μg·kg - 1 ·h - 1右美托咪定联合3 μg·kg - 1 ·h - 1布托啡诺可安全应用，且镇静剂不变。
关键词：剖宫产, 右美托咪定, 镇痛, 婴儿相对剂量, 麻醉
更新日期：2021-04-20
Patients and Methods: A total of 114 parturients between 24 and 43 years of age, with singleton pregnancy who underwent elective cesarean section under epidural anesthesia, were randomly allocated to four groups: group C received 0.9% sodium chloride after delivery, followed by butorphanol (3 μg·kg− 1·h− 1); patients in groups D1, D2, and D3 received 0.5 μg·kg− 1·h− 1 dexmedetomidine after delivery, followed by butorphanol (3 μg·kg− 1·h− 1) combined with dexmedetomidine 0.03, 0.05, and 0.08 μg·kg− 1·h− 1, respectively. The primary outcome was the visual analogue scale (VAS) score at 6 h after delivery when patients were at rest. Secondary outcome measures included VAS after delivery when patients were on movement and uterine cramping, Ramsay sedation scale (RSS), relative infant dose (RID) of dexmedetomidine, satisfaction with analgesia after surgery and symptoms of CNS depression in neonates.
Results: There were no significant differences in patient characteristics among the groups (P > 0.05). The VAS at all timepoints after delivery in groups D2 and D3 were significantly lower than in groups C and D1 (P < 0.001). RSS scores were clearly higher in group D3 than in the other three groups at 6 h and 12 h (P < 0.0001). RID in groups D1, D2, and D3 was 0.171%, 0.197%, and 0.370%, respectively. Compared with group D1, RID was higher in group D3 (P = 0.0079). Degree of satisfaction with analgesia was higher in groups D2 and D3 (P < 0.005).
Conclusion: Continuous intravenous infusion of 0.05 μg·kg− 1·h− 1 dexmedetomidine combined with 3 μg·kg− 1·h− 1 butorphanol could be safely applied in healthy parturients with satisfactory analgesia after cesarean section without changes in sedation.
Keywords: cesarean section, dexmedetomidine, analgesia, relative infant dose, anesthesia
中文翻译：
静脉注射不同浓度右美托咪定联合布托啡诺用于剖宫产术后镇痛的有效性和安全性：随机对照试验
目的：本研究旨在确定静脉注射不同浓度右美托咪定的有效性，并评估其与布托啡诺联合用于剖宫产产妇的母婴安全性。
患者与方法：将114例24~43岁的单胎妊娠产妇在硬膜外麻醉下择期剖宫产，随机分为4组：C组产后给予0.9%氯化钠，随后给予布托啡诺。 3 μg·kg - 1 ·h - 1 ); D1、D2、D3组患者分娩后给予0.5 μg·kg - 1 ·h - 1右美托咪定，随后给予布托啡诺（3 μg·kg - 1·h - 1 ) 分别与右美托咪定 0.03、0.05 和 0.08 μg·kg - 1 ·h - 1联合使用。主要结果是分娩后 6 小时患者休息时的视觉模拟评分 (VAS) 评分。次要结局指标包括分娩后患者运动和子宫痉挛时的 VAS、Ramsay 镇静量表 (RSS)、右美托咪定的婴儿相对剂量 (RID)、术后镇痛满意度和新生儿中枢神经系统抑制症状。
结果：各组患者特征差异无统计学意义（P > 0.05）。D2、D3组产后各时间点VAS均显着低于C、D1组（P< 0.001)。在 6 小时和 12 小时，D3 组的 RSS 评分明显高于其他三组（P < 0.0001）。D1、D2 和 D3 组的 RID 分别为 0.171%、0.197% 和 0.370%。与D1组相比，D3组RID较高（P =0.0079）。D2、D3组镇痛满意度较高（P <0.005）。
结论：健康产妇剖宫产术后连续静脉滴注0.05 μg·kg - 1 ·h - 1右美托咪定联合3 μg·kg - 1 ·h - 1布托啡诺可安全应用，且镇静剂不变。
关键词：剖宫产, 右美托咪定, 镇痛, 婴儿相对剂量, 麻醉
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