ObjectiveThis study aimed to find the best dose of dexmedetomidine in spinal anesthesia for cesarean section.Methods120 American Society of Anesthesiologists (ASA) Class I and II parturients undergoing elective cesarean delivery under spinal anesthesia were randomly allocated into four groups treated with intrathecal ropivacaine (12 mg) alone (Group R) or in combination with dexmedetomidine 5 μg (Group RD1), 7.5 μg (Group RD2) and 10 μg (Group RD3). Characteristics of spinal anesthesia, hemodynamic changes, adverse effects, stress reactions and neonatal outcomes were recorded in the four groups.ResultsPatients in Group RD1, RD2, and RD3 had significantly longer sustained sensory and motor block time than patients in Group R. All four groups had comparable onset times of sensory and motor block. The time for the level of sensory block to lower to S1 was longer in Group RD1 (411.07 ± 106.66 min), Group RD2 (397.03 ± 125.39 min) and Group RD3 (468.63 ± 116.43 min) than in Group R (273.60 ± 88.34 min) (p < 0.001). The time to recover from motor block to a Bromage score of IV was longer in Group RD1 (353.60.07 ± 137.28 min), Group RD2 (350.57 ± 118.01 min) and Group RD3 (404.67 ± 112.83 min) than in Group R (232.70 ± 93.29) (p < 0.01). The incidence of chills was significantly lower in the Group RD1, RD2, and RD3 than in the Group R (p < 0.001). There was no significant difference in the incidence of adverse effects such as hypotension, bradycardia, nausea, vomiting, hypoxemia and pruritus in the four groups (p > 0.05). There was no statistically significant visceral traction response or fentanyl use in the four groups (p > 0.05). Phenylephrine dosing was significantly higher in Group RD2 and RD3 than in Group R (p < 0.05), and there was no significant difference in phenylephrine dosing between Group RD1 and Group R (p > 0.05). There were no statistical differences in postnatal Apgar scores (1 min, 5 min after birth) (p > 0.05). The postoperative concentrations of β-endorphin (β-EP), cortisol (Cor) and tumor necrosis factor-α (TNF-α) in the Group RD1, RD2, and RD3 were lower than that in Group R (p < 0.05).ConclusionIntrathecal 5μg of dexmedetomidine as an adjuvant to ropivacaine relieved intraoperative chills, did not increase intraoperative and postoperative adverse effects, did not increase the amount of intraoperative vasoconstrictor used, and reduced intraoperative stress reactions as well as prolonged the duration of maternal sensory and motor block, so this dose is appropriate for cesarean section.Clinical Trial Registration:[www.chictr.org.cn/], identifier [ChiCTR2200056052].

Background: The objective of this study was to find ways to reduce intraoperative glandular secretion in patients by observing the effects of different depths of anesthesia on glandular secretion under Narcotrend monitoring (NT), to reduce the use of unnecessary anticholinergic drugs, and to improve the quality of anesthesia and patient comfort. Methods: Ninety patients who underwent total laparoscopic hysterectomy were randomly divided into four groups. Group L: intraoperative maintenance of anesthesia depth D0-D2, group M: intraoperative maintenance of anesthesia depth E0-E1, group H: long tocopherol 0.01 mg/kg was administered intravenously 10 min before surgery without monitoring the depth of anesthesia, and the mean arterial pressure (MAP), heart rate (HR), and adverse effects were compared in each group at six time points. The salivary secretion and respiratory gland secretion were compared among the groups. Results: Salivary secretion under general anesthesia decreased in all three groups compared with the basal value (P < 0.05), with the smallest decrease in group L (P < 0.05) and the largest decrease in group H (P < 0.001). The amount of respiratory gland secretion during the whole operation was from more to less in the order of group L, group M and group H. The dry mouth visual analogue scale(VAS)scores were lower in groups L and M than in group H (P < 0.05). Conclusion: General anesthesia suppresses the patient's glandular secretion, and the suppression becomes more pronounced as the anesthesia deepens. Maintaining the depth of anesthesia E0-E1 can effectively reduce the patient's glandular secretion, more stable intraoperative vital signs, and more comfortable patient awakening period without increasing the incidence of adverse reactions.