Effect Of Dexmedetomidine And Ondansetron On The Postoperative Quality Of Recovery Of Parturients With Cesarean Section Under Spinal Anesthesia

Objective: To study the effect of dexmedetomidine and ondansetron on the postoperative quality of recovery of parturients with cesarean section under spinal anesthesia by the QoR-40 scale.Method: 80 parturients with cesarean section under spinal anesthesia were selected;the patients were divided into test group(group D)and control group(group C)according to the method of random number table,40 cases in each group.In group D,0.08mg/kg(diluted to 10 mL with normal saline)of ondansetron was injected slowly 5minutes before spinal anesthesia,and in group C,10 m L normal saline was injected.Spinal anesthesia was performed in lateral position with 25 G spinal needle.After the fetus were removed and the umbilical cord were severed,the parturients in group D were slowly injected with a bolus of dexmedetomidine 0.5?g/kg,and then intravenously pumped at 0.5?g/kg/h;the parturients in group C were given the same volume of saline.Group D was given sufentanil 2?g/kg and dexmedetomidine 1?g/kg and ondansetron0.16mg/kg for postoperative intravenous analgesia,and group C was given sufentanil2?g/kg and ondansetron 0.16mg/kg for postoperative intravenous analgesia.The QoR-40 scores before cesarean section were observed and SBP,DBP,HR were recorded when the parturients entered the operating room(T0),after spinal anesthesia(T1),before intravenous pumping dexmedetomidine(Group D)or saline(Group C)(T3),after intravenous pumping dexmedetomidine(Group D)or saline(Group C)(T4),and atthe end of the operation(T5).The Ramsay sedation score 30 minutes after intravenous pumping,visceral stretch score,occurrence of chills,and Apgar score of newborns were recorded.The QoR-40 scores,lactation time and adverse reactions were recorded after cesarean section.Results: The SBP after spinal anesthesia in group D was higher than that in group C,and the difference was statistically significant(P<0.05).There was no significant difference in DBP and HR after spinal anesthesia between the two groups(P >0.05).Ramsay sedation of the parturients during group D was higher than that of group C,the incidence of bradycardia in group D was higher than that in group C and the difference was statistically significant(P <0.05).There was no significant difference in visceral traction score,neonatal Apgar score,and postoperative lactation time between the two groups(P> 0.05).There was no significant difference in the QoR-40 scores before cesarean section between the two groups(P> 0.05).Compared the QoR-40 after cesarean section between the two groups,the emotional state score,physical comfort score,pain scores and overall scores were higher in group D than these in group C,and the difference was statistically significant(P < 0.05);there was no significant difference in self-care ability scores and psychological support scores(P> 0.05).Conclusions: 1.Pre-injection of ondansetron before spinal anesthesia combined with dexmedetomidine for intraoperative sedation and postoperative analgesia can improve the postoperative recovery quality of the parturients after cesarean section without obvious adverse reaction,and do not affect the Apgar score of newborn.2.Injecting0.08mg/kg ondansetron before spinal anesthesia can reduce the decrease of systolic blood pressure after spinal anesthesia in parturients with cesarean section,and has no effect on diastolic blood pressure and heart rate.