Efficacy Of Dexmedetomidine Combined With Sufentanil For Patient-controlled Intravenous Analgesia After Caesarean Section

Efficacy of dexmedetomidine combined with sufentanil for patient-controlled intravenous analgesia after caesarean sectionObjective:To evaluate the efficacy of dexmedetomidine combined with sufentanil for patient-controlled intravenous analgesia after cesarean section.Methods:120 parturients aged 18-40yr undergoing caesarean section under spinal-epidural anesthesia were randomly assigned one of three groups (n=40 each):groupⅠ, groupⅡ, and groupⅢ. During operation as soon as the baby was born, a bolus of dexmedetomidine 0.5μg/kg was given iv inⅡandⅢgroups while in groupⅠnormal saline (NS) was given instead.ⅠandⅡgroups received PCIA with sufentanil (background infusion 0.015μg·kg-1·h-1; bolus dose 0.023μg/kg; lockout interval 8 min). GroupⅢreceived PCIA with sufentanil+dexmedetomidine (background infusion 0.015μg·kg-1·h-1+ dexmedetomidine 0.045μg·kg-1·h-1; bolus dose 0.023μg/kg+ dexmedetomidine 0.07μg/kg; lockout interval 8 min). Pain threshold and pain tolerance threshold were measured before cesarean section and 1 h after bolus dose of dexmedetomidine or NS. VAS, OAA/S, satisfaction scores and sufentanil consumption were recorded at 4,8,24 h after operation. Blood samples were obtained before anesthesia,1 h after bolus injection of dexmedetomidine, and 24 h after operation for determination of serum cortisol concentration.Results:Pain threshold and pain tolerance threshold at 1 h after bolus injection of dexmedetomidine were significantly increased as compared with the baseline before anesthesia in groupⅡand groupⅢand were significantly higher in groupⅡand groupⅢthan in groupⅠ. VAS scores and the consumption of sufentanil were significantly lower while the satisfactory score was significantly higher in groupⅢthan in groupⅡand groupⅢ. Serum cortisol concentration were significantly increased at 1 h after dexmedetomidine or NS injection as compared with the baseline before anesthesia in all 3 groups, but there was no significant difference in serum cortisol concentration among the 3 groups.Conclusions:Combination of dexmedetomidine with sufentanil for PCIA can significantly reduce the consumption of sufentanil and improve parturients satisfaction.