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| Clinical comparison of dexmedetomidine for anesthesia of women during the second cesarean section between epidural injection and intravenous infusion |
| Mianyang 404 Hospital, Mianyang, Sichuan Province, 621000 |
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Abstract To analyze the difference of anesthetic effect of epidural injection and intravenous infusion of dexmedetomidine of women during the second cesarean section. Methods: From January 2019 to March 2020, 85 pregnant women who would undergo the second cesarean section were selected and were randomly divided into observation group (45 cases) and control group (40 cases). The women in the observation group were given dexmedetomidine by epidural injection before operation, while the women in the control group were given dexmedetomidine by intravenous infusion before operation. The time of anesthesia onset, the time of anesthesia level to reach the highest, the time of sensory anesthesia, the sedation score, the analgesia duration, the analgesic drug consumption, the duration of the second stage of labor, Apgar score of newborn, and the rate of adverse reactions of the women were compared between the two groups. Results: The onset time of anesthesia (6.3±1.0 min) and the time of anesthesia level to reach the highest (13.1±1.7 min) of the women in the observation group were significant lower than those (8.7±1.3 min and 17.3±2.1 min) of the women in the control group, but the sensory block time (387.8±7.7 min) of the women in the observation group was significant longer than that (295.7±3.6 min) of the women in the control group (all P＜0.05). The duration of analgesia (159.6±13.6 min) of the women in the observation group was significant longer than that (146.3±10.3 min) of the women in the control group. The analgesic drug dosage (3.2±0.4 ug) and the second labor time (65.4±15.3 min) of the women in the observation group were significant lower than those (3.6±0.6 ug and 82.7±16.6 min) of the women in the control group (all P＜0.05). There were no significant differences in the sedation score and neonatal Apgar score between the two groups (P＞0.05). The incidence of complications (8.9%) of the women in the observation group was significant lower than that (25.0%) of the women in the control group (P＜0.05). Conclusion: During the second cesarean section, ropivacaine combined with epidural injection or intravenous infusion of dexmedetomidine has the similar sedative effects, and both has not adverse affect for the newborn. However, epidural injection of dexmedetomidine combined with ropivacaine has faster onset time of anesthesia and better analgesic effect with higher safety.
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