Possibility to use quanadex (dexmedetomidine) for caesarean section in patients with pre-eclampsia

Authors

  • Kim Yong­-Din Republican Specialized Scientific and Practical Medical Center of Obstetrics and Gynecology, Tashkent
  • N Nadyrkhanova Republican Specialized Scientific and Practical Medical Center of Obstetrics and Gynecology, Tashkent
  • R Tkachenko P. L. Shupyk National Medical Academy of Postgraduate Education, Ministry of Health of Ukraine
  • Yu Kulichkin St. Petersburg State Pediatric Medical University, Russia
  • F Nishanova Republican Specialized Scientific and Practical Medical Center of Obstetrics and Gynecology, Tashkent

DOI:

https://doi.org/10.31636/pmjua.v6i4.3

Keywords:

preeclampsia, dexmedetomidine, caesarean section

Abstract

A prospective, double­blind, randomized, con­trolled clinical trial was conducted at the Republican Spe­cialized Scientific and Practical Medical Center of Obstet­rics and Gynecology of the Ministry of Health of the Repub­lic of Uzbekistan. The inclusion criteria for pregnant wom­en in the study was preeclampsia. All women were divided into 2 groups. In group I, premedication was performed on the table with sibazon 5 mg. In group II, starting from the moment of premedication, 0.5 µg/kg of quanadex (Yuriya Pharm) was administered intravenously for 15 minutes. The maintaining dose was 0.5–0.8 µg/kg/h. 0.5 % hyper­baric longocaine heavy was administered intrathecally at the LII–LIV level. Hemodynamics was assessed by echocardi­ography. BAC and electrolytes, lactate, glucose, hematocrit were studied on a gas analyzer “BGA­102” Wondfo (Rain Sen Da), NTproBNP, Cystatin­C, interleukin­6 and protein S­100 were determined on an immunofluorescence ana­lyzer Finecare™ FIA MeterPlus/FS 113 (Wonfo), sedation was assessed using the Richmond scale. Newborns were assessed for Apgar scores in the 1st and 5th minutes.
The data obtained showed that patients randomized to the group with dexmedetomidine (Group II) were almost al­ways better able to awaken than patients in the group with sibazon, and were distinguished by better hemodynamic stability, antinociceptive protection for surgical and anes­thetic intervention, without pronounced arterial hypoten­sion and bradycardia. It did not cause significant adverse outcomes in newborns.

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References

Morgan E, Magid S. Michael M. Clinical Anesthesiology. Publishing house BINOM; 2003; 304. [In Russian]

Khodzhaeva ZS, Yarotskaya EL, Baranova II. International Federation of Gynecology and Obstetrics (FIGO) Preeclampsia Initiative: A Practical Guide for First Trimester Screening and Disease Prevention. Obstetrics and gynecology: opinion news, training. 2019; 7(4):32–60. [In Russian]

Marshalov DV, Shifman EM, Salov IA, Petrenko AP. Correction of the dose of local anesthetic in spinal anesthesia in pregnant women with obesity. Anesthesiology – resuscitation. 2014; 5:19–23. [In Russian]

Sadchikov DV, Arkhangelsky SM, Elyutin DV et al. Gestosis: (concept, classification, etiology, pathogenesis , diagnostics, intensive care): (Educational-methodical manual). Saratov; 1998; 62 p. [In Russian]

Abildgaard U, Heimdal K. Pathogenesis of the syndrome of hemoly-sis, elevated liver enzymes, and low platelet count (HELLP): a review. Euro-pean Journal of Obstetrics & Gynecology and Reproductive Biology [Inter-net]. Elsevier BV; 2013 Feb;166(2):117–23. Available from: https://doi.org/10.1016/j.ejogrb.2012.09.026

Brogly N, Guasch E. Hypertension control during caesarean section in patients with pre-eclampsia: is dexmedetomidine an option? Minerva Anestesiologica [Internet]. Edizioni Minerva Medica; 2018 Dec;84(12). Avail-able from: https://doi.org/10.23736/s0375-9393.18.12915-4

Cafiero T, Di Minno RM, Di Iorio C. QT interval and QT dispersion during the induction of anaesthesia: a comparison of remifentanil and fenta-nyl. European Journal of Anaesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 2006 Jun;23(Supplement 37):38. Available from: https://doi.org/10.1097/00003643-200606001-00134

Colin PJ, Hannivoort LN, Eleveld DJ, Reyntjens KMEM, Absalom AR, Vereecke HEM, et al. Dexmedetomidine pharmacodynamics in healthy volunteers: 2. Haemodynamic profile. British Journal of Anaesthesia [Inter-net]. Elsevier BV; 2017 Aug;119(2):211–20. Available from: https://doi.org/10.1093/bja/aex086

D’Angelo R, Smiley RM, Riley ET, Segal S. Serious Complications Related to Obstetric Anesthesia. Obstetric Anesthesia Digest [Internet]. Ovid Technologies (Wolters Kluwer Health); 2015 Sep;35(3):117. Available from: https://doi.org/10.1097/01.aoa.0000469450.28960.d4

Davy A, Fessler J, Fischler M, Le Guen M. Dexmedetomidine and general anesthesia: a narrative literature review of its major indications for use in adults undergoing non-cardiac surgery. Minerva Anestesiologica [In-ternet]. Edizioni Minerva Medica; 2017 Dec;83(12). Available from: https://doi.org/10.23736/s0375-9393.17.12040-7

Diagnosis, Evaluation, and Management of the Hypertensive Dis-orders of Pregnancy: SOGC Clinical Practice Guideline. No. 307, May 2014;

Hanoura S, Hassanin R, Singh R. Intraoperative conditions and quality of postoperative analgesia after adding dexmedetomidine to epidural bupivacaine and fentanyl in elective cesarean section using combined spinal-epidural anesthesia. Anesthesia: Essays and Researches [Internet]. Medknow; 2013;7(2):168. Available from: https://doi.org/10.4103/0259-1162.118947

Henke VG, Bateman BT, Leffert LR. Spinal Anesthesia in Severe Preeclampsia. Anesthesia & Analgesia [Internet]. Ovid Technologies (Wolters Kluwer Health); 2013 Sep;117(3):686–93. Available from: https://doi.org/10.1213/ane.0b013e31829eeef5

Knight M, Nair M, Tuffnell D et al. Improving Mothers’ Care: Les-sons learned to inform maternity care from the UK and Ire¬land Confidential Enquiries into Maternal Deaths and Mor¬bidity 2013-15. Oxford: University of Oxford; 2017.

Li C, Li Y, Wang K, Kong X. Comparative Evaluation of Remifen-tanil and Dexmedetomidine in General Anesthesia for Cesarean Delivery. Medical Science Monitor [Internet]. International Scientific Information, Inc.; 2015 Dec 7;21:3806–13. Available from: https://doi.org/10.12659/msm.895209

Nguyen V, Tiemann D, Park E, Salehi A. Alpha-2 Agonists. Anes-thesiology Clinics [Internet]. Elsevier BV; 2017 Jun;35(2):233–45. Available from: https://doi.org/10.1016/j.anclin.2017.01.009

Niu X-Y, Ding X-B, Guo T, Chen M-H, Fu S-K, Li Q. Effects of In-travenous and Intrathecal Dexmedetomidine in Spinal Anesthesia: A Meta-Analysis. CNS Neuroscience & Therapeutics [Internet]. Wiley; 2013 Oct 14;19(11):897–904. Available from: https://doi.org/10.1111/cns.12172

Pacher J, Brix E, Lehner R. The mode of delivery in patients with preeclampsia at term subject to elective or emergency Cesarean section. Ar-chives of Gynecology and Obstetrics [Internet]. Springer Science and Busi-ness Media LLC; 2013 Jul 13;289(2):263–7. Available from: https://doi.org/10.1007/s00404-013-2936-3

September 2011 EMA/789509/2011. Committee for Medicinal Products for Human Use (CHMP)

Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O’Neal PV, Keane KA, et al. The Richmond Agitation–Sedation Scale. American Journal of Respiratory and Critical Care Medicine [Internet]. American Thoracic Socie-ty; 2002 Nov 15;166(10):1338–44. Available from: https://doi.org/10.1164/rccm.2107138

Sun Y, Xu Y, Wang G-N. Comparative Evaluation of Intrathecal Bupivacaine Alone, Bupivacaine-fentanyl, and Bupivacaine-dexmedetomidine in Caesarean Section. Drug Research [Internet]. Georg Thieme Verlag KG; 2014 Sep 10;65(09):468–72. Available from: https://doi.org/10.1055/s-0034-1387740

Yoo KY, Kang DH, Jeong H, Jeong CW, Choi YY, Lee J. A dose–response study of remifentanil for attenuation of the hypertensive response to laryngoscopy and tracheal intubation in severely preeclamptic women under-going caesarean delivery under general anaesthesia. International Journal of Obstetric Anesthesia [Internet]. Elsevier BV; 2013 Jan;22(1):10–8. Available from: https://doi.org/10.1016/j.ijoa.2012.09.010

Zhang J, Zhou H, Sheng K, Tian T, Wu A. Foetal responses to dexmedetomidine in parturients undergoing caesarean section: a systematic review and meta-analysis. Journal of International Medical Research [Inter-net]. SAGE Publications; 2017 May 19;45(5):1613–25. Available from: https://doi.org/10.1177/0300060517707113

Возможность использования кванадекса  (дексмедетомидина) при кесаревом сечении у пациенток  с преэклампсией

Published

2022-02-11

How to Cite

1.
Yong­-Din K, Nadyrkhanova N, Tkachenko R, Kulichkin Y, Nishanova F. Possibility to use quanadex (dexmedetomidine) for caesarean section in patients with pre-eclampsia. PMJUA [Internet]. 2022 Feb. 11 [cited 2024 Mar. 28];6(4):28-36. Available from: https://painmedicine.org.ua/index.php/pnmdcn/article/view/277

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