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| Anesthetic effect of dexmedetomidine combined with spinal epidural anesthesia during cesarean section of women with preeclampsia and its influence on the postoperative recovery of these women |
| The First Hospital of Huai'an Affiliated to Nanjing Medical University, Nanjing, Jiangsu Province, 223300 |
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Abstract To investigate the anesthetic effect of dexmedetomidine (Dex) by intraoperative infusion combined with spinal-epidural anesthesia during cesarean section of women with preeclampsia (PE), and to study its influence on the postoperative recovery quality of these women. Methods: From January 2021 to August 2022, 76 pregnant women with PE who wanted cesarean section were selected and were randomly divided into two groups (33 cases in each group). The women in group A were infused with Dex for 0.5μg/kg/h，and after 10min, Dex 0.2μg/kg/h pumped till to closed abdomen. The women in group B were infused the same volume of normal saline. The levels of S100 protein and neuronspecific enolase (NSE) of the women in the two groups were detected before administration (T1), immediately after operation (T2), 6 hours after operation (T3), 12 hours after operation (T4), and 24 hours after operation (T5). The levels of inflammatory cytokines, such as IL-6, TNF-α, and CRP of the women in the two groups were detected at T1 and T5. The cardiac output index (CI), mean arterial pressure (MAP), hear rate (HR), and Ramsay sedation score of the women in the two groups were monitored at T1, the 10min and 20min of drug used, and T5, respectively. The postoperative adverse reactions of the women and the neonatal Apgar scores in the two groups were recorded. Results: The HR of the women in group A in the 10min of drug used was significantly lower than that of the women in group B. The values of CI, MAP, and HR of the women in group A in the 20min of drug used were significantly lower than those of the women in group B, the values of CI and HR of the women in group A at T5 were significantly lower than those of the women in group B (P＜0.05), and there was no significant difference in the MAP value of the women between the two groups (P＞0.05). The S100β level of the women in group A at T3 was significantly lower than that of the women in group B, and the levels of S100β and NSE of the women in group A at T4 and T5 were significantly lower than those of the women in group B (P＜0.05). The levels of IL-6, TNF-α, and CRP of the women in both groups at T5 were significantly higher than those at T1, but which of the women in group A was significantly lower than that of the women in group B (P＜0.05). The Ramsay sedation scores of the women in group A in 10min and 20min after drugs used and at T5 were significantly higher than those of the women in group B (P＜0.05). The incidences of hypotension (15.8%), hypertension (36.8%), duration of postoperative dizziness (7.3±1.6h), duration of postoperative blurred vision (4.7±1.3h), and hospital stay (5.3±0.3d) of the women in group A were all significantly lower than those (42.1%, 63.2%, 10.0±1.4h, 7.3±1.3h, and 5.9±0.3d) of the women in group B (all P＜0.05). There was no significant difference in Apgar score of newborns at 1min and 5min after birth between the two groups (P＞0.05). Conclusion: Dex infusion during caesarean section of the women with PE has good analgesic and sedative effects, which can reduce the brain injury, reduce the postoperative adverse reactions, improve the quality of postoperative recovery of the women, and has no adverse effect on the quality of newborn birth.
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