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Use of Dexmedetomidine + Low-Dose Norepinephrine to prevent hypotension after cesaresan section

Cesaresan Section Cesaresan Section
Cesaresan Section Cesaresan Section

This randomized controlled trial sought to determine the clinical effect of continuous infusion of Dexmedetomidine combined with low-dose Norepinephrine for the prevention of supine hypotension, and the safety and effectiveness for parturients and newborns.

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Key take away

A combination of Dexmedetomidine and low-dose Norepinephrine continuous pumping is beneficial and safe to prevent hypotension after cesaresan section.

Background

This randomized controlled trial sought to determine the clinical effect of continuous infusion of Dexmedetomidine combined with low-dose Norepinephrine for the prevention of supine hypotension, and the safety and effectiveness for parturients and newborns.

Method

Overall, 160 puerperaes (age 20–35 years) that underwent elective cesarean sections were chosen. By using a random number table method, the volunteers were divided evenly into the N group (Norepinephrine), D group (Dexmedetomidine), S group (saline), and DN group (Dexmedetomidine mixed with Norepinephrine). At one and five minutes, recording of umbilical cord venous blood gas measurements and Apgar ratings was done.

Result

Body mass index, age, gestational age, bleeding volume, fluid supplement volume, Apgar ratings of newborns at the first and fifth minutes, and blood gas values of the umbilical cord's arterial and venous systems did not differ statistically significantly amongst the four groups. Following spinal anesthesia, the occurrence of supine hypotension, the number of norepinephrine supplements, the amount of norepinephrine administered in supplemental dosages, and the occurrence of adverse events were all considerably lower in the D, N, and DN groups compared to the S group.

In the DN group following spinal anesthesia, the frequency of supine hypotension, the number of additional norepinephrine, the additional dose of norepinephrine, and the frequency of adverse responses were all considerably lower than in group D. In the DN arm following spinal anesthesia, the occurrence of supine hypotension, the number of additional norepinephrine, norepinephrine's additional dose, and the occurrence of adverse responses were all noticeably lower than in N arm.

Conclusion

When paired with continuous pumping of low-dose Norepinephrine, Dexmedetomidine can successfully avoid the onset of supine hypotension, limit the occurrence of other adverse events, and have no clear negative effects on neonates.

Source:

Journal of Healthcare Engineering

Article:

Dexmedetomidine Combined with Low-Dose Norepinephrine Continuous Pumping to Prevent Hypotension after Cesaresan Section: A Randomized Controlled Trial

Authors:

Jin Zhang et al.

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