BACKGROUND During general anaesthesia, endotracheal intubation of patients with pre-eclampsia causes stimulation of the sympathetic nervous system and catecholamine release, which may lead to maternal and neonatal complications. OBJECTIVE To attenuate both the stress response and the haemodynamic response to tracheal intubation in patients with pre-eclampsia. DESIGN A randomised, double-blind, controlled study. SETTING Single University Hospital. PATIENTS Sixty patients aged 18 to 45 years with pre-eclampsia receiving general anaesthesia for caesarean section. INTERVENTIONS The patients were randomly allocated to three groups. Groups D1and D2 received an infusion of dexmedetomidine 1 μg kg−1 over the 10 min before induction of general anaesthesia, then 0.4 and 0.6 μg kg−1 h−1 dexmedetomidine, respectively. Group C received equivalent volumes of 0.9% saline. MAIN OUTCOME MEASURES The primary outcome was the effect of dexmedetomidine on mean arterial blood pressure measured before induction of general anaesthesia at 1 and 5 min after intubation, and then every 5 min until 10 min after extubation. The secondary outcomes were blood glucose and serum cortisol (measured before induction of general anaesthesia, and at 1 and 5 min after intubation), postoperative visual analogue pain scores, time to first request for analgesia, the total consumption of analgesia, Ramsay sedation score, maternal and placental vein blood serum levels of dexmedetomidine and neonatal Apgar score at 1 and 5 min. RESULTS At all assessment times, the mean arterial pressures were significantly lower in the dexmedetomidine groups than in the control group. Compared with group C, the heart rate was significantly lower in both groups D1 and D2. In group D2, the heart rate was lower than in group D1. Serum glucose and cortisol were significantly higher in the controls than in either group D1 or D2. Group D2 patients were significantly more sedated on arrival in the recovery room followed by D1. Time to first analgesia was significantly longer in groups D2 and D1 than in group C, and the visual analogue pain scores were significantly lower in groups D1 and D2 than in group C at 1, 2, 3 and 5 h. Total morphine consumption was significantly lower in groups D1 and D2 than in the control group. There was no difference in Apgar scores across the three groups despite significantly higher dexmedetomidine concentrations in group D2 (both maternal and placental vein) than in group D1. CONCLUSION Administration of dexmedetomidine in doses 0.4 and 0.6 μg kg−1 h−1 was associated with haemodynamic and hormonal stability, without causing significant adverse neonatal outcome. TRIAL REGISTRATION Pan African Clinical Trial Registry (PACTR201706002303170), (www.pactr.org). Correspondence to Ashraf M. Eskandr, MD, Department of Anesthesia, ICU and Pain Therapy, Faculty of Medicine, Menoufiya University, 3 Yassin Abd-Elghafar Street, Shibin El-koom, Egypt E-mail: ameskandr@yahoo.com © 2018 European Society of Anaesthesiology
http://ift.tt/2EjETBM
Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com
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- Patient, Surgeon, and Anesthesiologist Satisfactio...
- Acquired Central Hypoventilation Syndrome Unmasked...
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- The clinical value of HPV E6/E7 and STAT3 mRNA det...
- Colchicine in dermatology: A review
- Colchicine in dermatology: A review
- Dystrophic calcinosis cutis within burns, successf...
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- Is spinal anaesthesia in young infants really safe...
- Acute pain management in children: challenges and ...
- Intensive care practitioner: I forgot half the thi...
- Long-term neurocognitive outcomes following surger...
- Non-enhanced MRI in combination with color Doppler...
- Strain hardening reduces energy absorption efficie...
- Dexmedetomidine as a part of general anaesthesia f...
- Low anaesthetic waste gas concentrations in postan...
- Low perfusion pressure is associated with renal tu...
- Dexmedetomidine as a part of general anaesthesia f...
- Low anaesthetic waste gas concentrations in postan...
- Low perfusion pressure is associated with renal tu...
- Ethosuximide-induced Stevens–Johnson syndrome: Ben...
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- In situ monitoring of PTHLH secretion in neuroblas...
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- Cholesterol and vitamin E-conjugated PEGylated pol...
- Albumin coated cadmium nanoparticles as chemothera...
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- Profiling cytokine levels in chlorhexidine and EGC...
- Editorial Board
- Influence of thread shape and inclination on the b...
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- The effect of hydrofluoric acid concentration on t...
- Genotoxic and mutagenic potential of camphorquinon...
- In memoriam of Professor David B. Mahler (1923–2017)
- In-vitro wear of natural tooth surface opposed wit...
- Strength and fracture toughness of zirconia dental...
- 8DSS peptide induced effective dentinal tubule occ...
- Development of a novel dental resin cement incorpo...
- Optimization of large MOD restorations: Composite ...
- [Recurrent frontal swelling in a child].
- Erratum to: Long-term changes in multimodal intens...
- Human coronavirus circulation in the United States...
- Pathophysiology of peste des petits ruminants in s...
- Safety of live-attenuated measles-mumps-rubella an...
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