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| Effect of dexmedetomidine on inflammatory stress response of pregnant women with gestational diabetes mellitus |
| The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710061 |
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Abstract To explore the effect of dexmedetomidine on stress response during cesarean section of pregnant women with gestational diabetes mellitus (GDM). Methods: 170 women with GDM were selected and were divided into observation group and control group according to whether dexmedetomidine injected into subarachnoid space during cesarean section from March 2018 to November 2019. All these women were anesthetized with 2.5ml 0.5% bupivacaine injected into subarachnoid. The women in the observation group were additional injected with 2 units (5μg) of dexmedetomidine into the subarachnoid space, while the women in the control group were additional injected the same amount of normal saline into the subarachnoid space. Ramsay Sedation score and VAS score were used to evaluate the effect of sedation and analgesia at different time point after operation. Adverse reactions rate and operation time of the women, and the neonatal Apgar score in the two groups were recorded. The levels of epinephrine, norepinephrine, blood glucose, interleukin-6 (IL-6), IL-8, and tumor necrosis factor-α (TNF-α) of the women in the two groups were detected before and after operation. Results: From 8h after operation, the pain score at different time point of the women in observation group was significant lower than that of the women in control group (P<0.05), and there was no significant difference in postoperative sedation score of the women between the two groups (P>0.05). The postoperative levels of epinephrine, norepinephrine, blood glucose, IL-6, and TNF–α of the women in the observation group were significant lower than those of the women in the control group, but the level of IL-8 of the women in the observation group was significant higher (P<0.05). No adverse reactions such as hypotension, bradycardia, and respiratory depression were found in the two groups. There were no significant differences in the time of reaching the maximum block plane and neonatal Apgar score between the two groups (P>0.05). The incidences of nausea and vomiting (12.3%) and chills (8.7%) of the women in the observation group were significant lower than those (26.3% and 22.2%) of the women in the control group (P<0.05). Conclusion: Dexmedetomidine can effectively inhibit the occurrence of inflammatory stress reaction of pregnant women with GDM during cesarean section, which can optimize the anesthesia effect of combined spinal and epidural anesthesia, and reduce the incidences of postoperative nausea, vomiting and shivering.
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