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Dexmedetomidine as a Part of General Anesthesia for Cesarean Delivery in Patients With Preeclampsia

A Randomized Double-blinded Trial

Eskandr, A.M.; Metwally, A.A.; Ahmed, A.A.; Elfeky, E.M.; Eldesoky, I.M.; Obada, M.A.; Abd-Elmegid, O.A.

Obstetric Anesthesia Digest: March 2019 - Volume 39 - Issue 1 - p 3–5
doi: 10.1097/01.aoa.0000552874.61374.d6
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(Eur J Anaesthesiol. 2018;35:372–378)

In patients with preeclampsia, endotracheal intubation during the induction of general anesthesia causes stimulation of the sympathetic nervous system and catecholamine release, leading to maternal hypertension and tachycardia that could contribute to maternal and neonatal complications. A variety of sedative and opioid drugs have been used in an attempt to blunt this stress response during endotracheal intubation. However, these drugs cross the uteroplacental barrier, and may affect the fetus. Therefore, the search for a drug that has minimal placental transfer to the fetus while also inhibiting the stress response to intubation has led to increasing use of α2 adrenergic agonists such as dexmedetomidine. The current randomized, double-blind, controlled study investigated the use of 2 different doses of dexmedetomidine (0.4 and 0.6 μg/kg) as part of a general anesthetic for patients with preeclampsia undergoing cesarean delivery. The effects of dexmedetomidine on the intubation-related stress response, intraoperative hemodynamics, postoperative analgesia, and fetal outcome were assessed.

Department of Anesthesia, ICU and Pain Therapy, Faculty of Medicine, National Liver Institute, Menoufiya University, Shibin El-koom, Egypt

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