Comparative Evaluation of Remifentanil and Dexmedetomidine in General Anesthesia for Cesarean Delivery

Li, Cheng‐Wen; Li, Yandong; Wang, Kun; Kong, Xiangang

doi:10.12659/msm.895209

Cited by 33 publications

(46 citation statements)

References 37 publications

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“…While group R showed no significant changes all over the surgery in the hemodynamics. These desirable effects of remifentanil on hemodynamic stability has been shown in previous studies using different doses of remifentanil [24][25][26][27].…”

Section: Discussionsupporting

confidence: 62%

The Effects of Dexmedetomidine or Remifentanil Continuous Infusion on End- Tidal Sevoflurane Concentration in Patients Undergoing Laparoscopic Cholecestectomies, Monitored by Bispectral Analysis

Mogahed¹,

Anwar²

2017

J Anesth Clin Res

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Background and Objective: Owing to the hemodynamic response to pneumoperitoneum, laparoscopic is not devoid of risk; adjuvants have been used to decrease the dose of volatile agents and their side effects and to blunt the hemodynamic response. This study was designed to compare the effect of dexmedetomidine and remifentanil on sevoflurane expired fraction concentration (EF sevo) in general anesthesia, monitored by BIS. Hemodynamic response, postoperative recovery profile, analgesic requirements and PONV were also recorded.

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Section: Discussionsupporting

confidence: 62%

The Effects of Dexmedetomidine or Remifentanil Continuous Infusion on End- Tidal Sevoflurane Concentration in Patients Undergoing Laparoscopic Cholecestectomies, Monitored by Bispectral Analysis

Mogahed¹,

Anwar²

2017

J Anesth Clin Res

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“…The dose and intervention of DEX we chose was similar to those used in previous research. 16,30 Dexmedetomidine can be safely used in adults, and the dose used in this study is completely acceptable. 31 There was no significant difference between the DEX group and the standard care group in drugrelated adverse events (such as severe bradycardia or fluctuation in blood pressure), which is in agreement with other reports.…”

Section: Discussionmentioning

confidence: 93%

<p>Impact of Intraoperative Infusion and Postoperative PCIA of Dexmedetomidine on Early Breastfeeding After Elective Cesarean Section: A Randomized Double-Blind Controlled Trial</p>

Wang

Fang

Liu

et al. 2020

DDDT

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Objective: Few studies have investigated the effects of dexmedetomidine (DEX) on breastfeeding after cesarean delivery. A randomized double-blind controlled trial was conducted to investigate whether the administration of DEX, immediately after delivery and for patient-controlled intravenous analgesia (PCIA), can be beneficial for breastfeeding. Patients and Methods: One hundred sixty parturients scheduled for elective cesarean section under spinal anesthesia were randomly allocated to the DEX group (a loading dose of DEX was pumped at 0.5 μg/kg within 10 min, followed by a further infusion of DEX at 0.5 μg/kg/h until the end of the surgery and PCIA for 2 days with DEX plus sufentanil) or the standard care group (infusion saline intraoperatively, and PCIA for 2 days with sufentanil). The number of days required to switch to exclusive breastfeeding within six weeks of delivery, the time to first lactation and breast milk volume on day 1 and day 2 after delivery were recorded. Recovery quality, comfort, anxiety, depression, postoperative analgesia, and adverse reactions of parturients were also assessed. Results: Compared with the standard care group, parturients in the DEX group could be converted to exclusive breastfeeding earlier (11 [14] vs 8 [10] days, log-rank P=0.025), the first lactation time was sooner (28.38 [13.82] vs 33.79 [14.85] hrs, P=0.024), and the amount of breast milk on the second day after delivery increased (P=0.012). There was no difference between the two groups in postpartum uterine contraction pain, but postpartum rest and movement VAS scores and recovery quality score in the DEX group were better than those in the standard care group (all P<0.05). Moreover, the hospital anxiety and depression scale and anxiety subscale score on the second day after delivery and the comfort score on the third day after delivery in the DEX group were significantly better than those in the standard care group (5 [5] vs 6 [8], 2 [2] vs 3 [3], 83.58 [6.75] vs 80.48 [6.58]; P=0.013, P=0.005, P=0.006, respectively). The incidence of adverse events, such as bradycardia, vomiting, hypersomnia, hypertension and hypotension, was not significantly different between the DEX and standard care groups (6.9% vs 2.7%, 5.6% vs 13.7%, 4.2% vs 0%, 5.6% vs 2. 7%, 11.1% vs 8.2%; P=0.275, P=0.158, P=0.366, P=0.681, P=0.556, respectively), except more parturients experienced nausea in the standard care group than in the DEX group (28.8% vs 11.1%, P=0.012). Furthermore, there was no difference in Neonatal Behavioral Neurological Assessment scores on the first and second days after delivery between the DEX and standard care groups (38 [3] vs 37 [2], 38.5 [2] vs 38 [2]; P=0.173, P=0.312, respectively). Conclusion: The application of DEX in the perioperative period of cesarean section was not only conducive to the early conversion of infant feeding to exclusive breastfeeding but could also improve the recovery quality and comfort of the parturient, optimize analgesia, shorten the time to first lactation, and increase lactation.

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“…1 Both fentanyl and dexmedetomidine is known to decrease the manifestation of sympathetic nervous system activation. 1,[4][5][6][7][8][9][10][11][12][13] In the present study, heart rate significantly decreased in the dexmedetomidine group when compared to fentanyl group immediately after study drug infusion and there was statistically significant reduction in heart rate for up to 5 min after intubation in both the groups. Although heart rate increased after intubation in both the groups, the magnitude was lower in the Dexmedetomidine group.…”

Section: Discussionmentioning

confidence: 64%

“…10 Dexmedetomidine has also been compared to remifentanil, esmolol and lignocaine. 5,11,12,13 In these randomized studies, dexmedetomidine was found to be of similar efficacy to remifentanil albeit with less potentials for respiratory depression, whereas it was superior compared to esmolol or lignocaine. 11,12,13 Bradycardia was observed in one patient each in the study by Gunalan et al and Kharwar et al 6,7 No such adverse effect was observed in our study.…”

Section: Discussionmentioning

confidence: 93%

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Effects of Preanesthetic Single Dose Intravenous Dexmedetomidine Versus Fentanyl on Hemodynamic Response to Endotracheal Intubation - A Clinical Comparative Study

Konwar¹,

Barman²,

Saikia³

et al. 2015

jebmh

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INTRODUCTIONMany pharmacological agents have been evaluated in regards to their efficacy of blunting the adverse cardiovascular response to laryngoscopy and tracheal intubation. The aim of this study was to evaluate the efficacy of dexmedetomidine compared to fentanyl in blunting the haemodynamic response to laryngoscopy and intubation. METHODSixty patients were randomly allocated into two groups (30 patients in each group). The group D received intravenously 1 µgm/kg dexmedetomidine infusion and group F received 2µgm/kg fentanyl infusion. The study drugs were prepared in an identical looking container and were infused fifteen minutes prior to induction of anaesthesia. The study drugs were infused over a period of ten minutes and all the patients underwent a similar anaesthetics technique. Heart rate (HR) and blood pressure (systolic, diastolic and mean blood pressure) were noted at baseline, at the end of infusion of the study drugs, after induction of anaesthesia, immediately after laryngoscopy and intubation and at 1, 3, 5, 7 and 10 minutes after laryngoscopy and intubation. RESULTSHR significantly decreased in the group D when compared to group F immediately after study drug infusion and there was statistically significant reduction in heart rate for up to 5 min after intubation in both the groups. Although HR increased after intubation in both the groups, the magnitude was lower in the group D. In both the groups, laryngoscopy and intubation led to an increase in systolic, diastolic and mean arterial pressure; the magnitude was lower in the group D. CONCLUSIONDexmeditomidine (1µ/kg) attenuates these untoward responses of laryngoscopy and intubation more effectively than fentanyl (2 µ/kg) when administered as bolus dose in the pre-induction period of general anaesthesia. HOW TO CITE THIS ARTICLE:Konwar C, Barman P, Saikia P et al. Effects of preanesthetic single dose intravenous dexmedetomidine versus fentanyl on hemodynamic response to endotracheal intubation-a clinical comparative study.

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Comparative Evaluation of Remifentanil and Dexmedetomidine in General Anesthesia for Cesarean Delivery

Cited by 33 publications

References 37 publications

The Effects of Dexmedetomidine or Remifentanil Continuous Infusion on End- Tidal Sevoflurane Concentration in Patients Undergoing Laparoscopic Cholecestectomies, Monitored by Bispectral Analysis

The Effects of Dexmedetomidine or Remifentanil Continuous Infusion on End- Tidal Sevoflurane Concentration in Patients Undergoing Laparoscopic Cholecestectomies, Monitored by Bispectral Analysis

<p>Impact of Intraoperative Infusion and Postoperative PCIA of Dexmedetomidine on Early Breastfeeding After Elective Cesarean Section: A Randomized Double-Blind Controlled Trial</p>

Effects of Preanesthetic Single Dose Intravenous Dexmedetomidine Versus Fentanyl on Hemodynamic Response to Endotracheal Intubation - A Clinical Comparative Study

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