Effects of dexmedetomidine hydrochloride on hemodynamics, postoperative analgesia and cognition in cesarean section

Kong, Dehua; Bai, Jianhua; Ma, Suqiao; Liu, Cong; Liu, Yang; Kong, Xiangang

doi:10.3892/etm.2018.6363

Cited by 11 publications

(10 citation statements)

References 22 publications

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“…It is a specific marker of the damage of the central nervous system, and its sensitivity is ideal. Therefore, it can be used as a biochemical indicator for the clinical detection of brain damage [ 26 ]. Under normal physiological conditions, the level of S-100 β protein in serum is shallow.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Different Dexmedetomidine Doses on Cognitive Function at Early Period of Patients Undergoing Laparoscopic Extensive Total Hysterectomy

Huang

Xiao

et al. 2021

Journal of Healthcare Engineering

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Background. This study aims to analyze the influence of different dexmedetomidine doses on cognitive function. It works on early periods of patients undergoing laparoscopic extensive total hysterectomy. Method. 119 patients with gynecological cancer underwent a laparoscopic extensive total hysterectomy. The operation was performed at the Affiliated Women’s and Children’s Hospital of Xiamen University from January 2019 to June 2020. The score of MoCA and the level of TNF-α, IL-6, S-100β protein, NSE, and GFAP of each group were compared 1 day before and after operation and 3 and 7 days after operation. Result. In four groups, remifentanil, sufentanil, and propofol were given in the following order: group A > group D > group C > group B. Group A > group D > group C in terms of time spent in the recovery room, extubation, and recovery from anesthesia. The difference between groups B and C was not significant ( P > 0.05 ). Compared with group A, group B scored higher in MoCA at 1 day (T1), 3 days (T2), and 7 days (T3) after operation ( P < 0.05 ). At the same scoring point, the score was group B > group C > group D > group A. The POCD of four groups all occurred at 3 days after surgery. Compared with the T0 point, the level of TNF-α and IL-6 of the four groups at T1 and T2 was significantly increased ( P < 0.05 ). At T3, the level of TNF-α and IL-6 gradually decreased. At various periods, the levels of S-100 protein, NSE, and GFAP in groups B, C, and D were lower than those in group A (P0.05). Group B had a substantially higher rate of bradycardia than the other three groups (P0.05). The incidence of chills, respiratory depression, and restlessness in group A differed significantly from the other three groups ( P < 0.05 ). Conclusion. Using 0.5 μg/kg dexmedetomidine during the perianaesthesia can effectively reduce anesthetic drugs in patients. They had a laparoscopic extensive complete hysterectomy, which helps to reduce the adverse responses and the occurrence of POCD while also protecting brain function.

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Section: Discussionmentioning

confidence: 99%

The Influence of Different Dexmedetomidine Doses on Cognitive Function at Early Period of Patients Undergoing Laparoscopic Extensive Total Hysterectomy

Huang

Xiao

et al. 2021

Journal of Healthcare Engineering

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“…Clonidine 1.2 mcg/ml/bupivacaine 0.1% infused epidural postcesarean for 24 h provided good analgesia with no need for supplemental opioids for 70% of parturients with opioid use disorder on buprenorphine [ 44 , 51 ]. Dexmedetomidine 4 mg IT significantly decreased VAS scores during and immediately after (2.1 ± 1 vs 3.6 ± 1, P < 0.001) cesarean surgery [ 52 ]. Dexmedetomidine as IV infusion of 0.2–1.4 mcg/kg/h after a load of 1 mcg/kg may also be helpful [ 26 ••].…”

Section: Introductionmentioning

confidence: 99%

Enhanced Recovery After Cesarean: Current and Emerging Trends

Patel

Zakowski

2021

Curr Anesthesiol Rep

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Purpose of Review What are the latest enhanced recovery elements for cesarean delivery? Recent Findings Enhanced recovery after cesarean delivery (ERAC) provides an evidenced-based system to improve maternal outcomes, functional recovery, maternal-infant bonding, and patient experience. Postsurgical recovery has evolved from a one-dimensional pain score to a holistic multidimensional approach emphasizing faster functional recovery. ERAC involves multidisciplinary efforts of the anesthesiologist, obstetrician, nursing, hospital, and patient. Components of ERAC include preoperative patient education, limited fasting, carbohydrate load, limiting opioids intra- and postoperatively, using scheduled non-opioid analgesics and supplementing with advanced therapies for women at higher risk for pain. ERAC protocols reduce opioid consumption, reduce length of stay, and improve maternal and neonatal outcomes. Summary Implementing ERAC standardized care will likely be the most important change you can make in your practice to improve outcomes, improve quality care, help address racial disparities, and minimize opioid exposure and potential for addiction.

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“…32 This accordingly reduced delivery cost. Meanwhile, primipara usually experiences more anxious and prolonged delivery than multipara, 33 which may extend the length of stay before and after birth. The disparities in the results mentioned above may come courtesy of the heterogeneity of the samples.…”

Section: Discussionmentioning

confidence: 99%

Medical expenditure of women during pregnancy, childbirth and puerperium at the beginning of China’s universal two-child policy enactment: a population-based retrospective study

et al. 2022

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ObjectivesTo describe and explore women’s medical expenditures during pregnancy, childbirth and puerperium at the beginning of the universal two-child policy enactment in China.DesignPopulation-based retrospective study.SettingDalian, China.ParticipantsUnder the System of Health Accounts 2011 framework, the macroscopic dataset was obtained from the annual report at the provincial and municipal levels in China. The research sample incorporated 65 535 inpatient and outpatient records matching International Classification of Diseases, 10th Revision codes O00–O99 in Dalian city from 2015 through 2017.Primary and secondary outcome measuresThe study delineates women’s current curative expenditure (CCE) during pregnancy, childbirth and puerperium at the beginning of the universal two-child policy in China. The temporal changes of medical expenditure of women during pregnancy, childbirth and puerperium at the beginning of China’s universal two-child policy enactment were assessed. The generalised linear model and structural equation model were used to test the association between medical expenditure and study variables.ResultsUnlike the inverted V-shaped trend in the number of live newborns in Dalian over the 3 studied years, CCE on pregnancy, childbirth and puerperium dipped slightly in 2016 (¥260.29 million) from 2015 (¥263.28 million) and saw a surge in 2017 (¥288.65 million). The ratio of out-of-pocket payment/CCE reduced year by year. There was a rapid increase in CCE in women older than 35 years since 2016. Length of stay mediated the relationship between hospital level, year, age, reimbursement ratio and medical expenditure.ConclusionsThe rise in CCE on pregnancy, delivery and puerperium lagged 1 year behind the surge of newborns at the beginning of China’s universal two-child policy. Length of stay acted as a crucial mediator driving up maternal medical expenditure. Reducing medical expenditure by shortening the length of stay could be a feasible way to effectively address the issue of cost in women during pregnancy, childbirth and puerperium.

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Effects of dexmedetomidine hydrochloride on hemodynamics, postoperative analgesia and cognition in cesarean section

Cited by 11 publications

References 22 publications

The Influence of Different Dexmedetomidine Doses on Cognitive Function at Early Period of Patients Undergoing Laparoscopic Extensive Total Hysterectomy

The Influence of Different Dexmedetomidine Doses on Cognitive Function at Early Period of Patients Undergoing Laparoscopic Extensive Total Hysterectomy

Enhanced Recovery After Cesarean: Current and Emerging Trends

Medical expenditure of women during pregnancy, childbirth and puerperium at the beginning of China’s universal two-child policy enactment: a population-based retrospective study

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