The results showed that , compared with placebo , pethidine , fentanyl , dexmedetomidine , and sufentanil significantly reduced the incidence of perioperative shivering .
In addition , compared with sufentanil , fentanyl showed no impact on haemodynamic stability and the incidence of pruritus .
CONCLUSION Pethidine , fentanyl , dexmedetomidine , and sufentanil appear to be effective for preventing perioperative shivering in puerperae undergoing cesarean sections .
Considering the risk-benefit profiles of the included neuraxial adjuvants , fentanyl is probably the optimal choice
BACKGROUND Perioperative shivering is clinical ly common during cesarean sections under neuraxial anesthesia , and several neuraxial adjuvants are reported to have preventive effects on it .
However , the results of current studies are controversial and the effects of these neuraxial adjuvants remain unclear .
AIM To evaluate the effects of neuraxial adjuvants on perioperative shivering during cesarean sections , thus providing an optimal choice for clinical application .
[Application of dexmedetomidine combined with ropivacaine in the cesarean section under epidural anesthesia].
OBJECTIVE To explore the anesthetic effect and neonatal effects of dexmedetomidine combined with ropivacaine in the cesarean section under epidural anesthesia . METHODS Between January 2012 and March 2013 at the First Affiliated Hospital with Nanjing Medical University , sixty parturients with a single baby at full term in vertex presentation scheduled for caesarean section under epidural anesthesia , were r and omly divided into 3 groups ( n = 20 each ) according to the r and om digits table : dexmedetomidine + ropivacaine ( RD ) , fentanyl + ropivacaine ( RF ) and normal saline + ropivacaine ( RN ) . After identification of the epidural space and a negative aspiration test for blood or cerebrospinal fluid , 15 ml of 0.75 % ropivacaine , was administered epidurally in three the groups with addition of 1 µg/kg of dexmedetomidine in RD group , 1 µg/kg of fentanyl in RF group and 2 ml of normal saline in RN group . Recording the mean arterial pressure ( MAP ) and heat rate ( HR ) before anesthesia ( T(0 ) ) , at 10 min ( T(1 ) ) and 30 min ( T(2 ) ) after the end of epidural administration , and at end of operation ( T(3 ) ) . Recording the onset time , maximum sensory analgesic level , time to maximum sensory analgesic level , time to two segmental dermatomal regressions , and time to chief complaint of postoperative pain . The modified bromage degrees , sedation scores and traction reaction were also assessed . The Apgar scores at 1 and 5 min were also recorded after delivery , and the blood sample s were drawn from umbilical vein for gas analysis . RESULTS MAP , HR and the motor block ( Bromage scale ) were no statistics differences among the three groups ( P > 0.05 ) . Compared with RN group , the onset time and the time to maximum sensory analgesic level were significantly earlier [ ( 6.3 ± 2.4 ) , ( 8.7 ± 2.3 ) min vs ( 10.9 ± 2.7 ) min ; ( 11.5 ± 3.9 ) , ( 16.2 ± 4.6 ) min vs(19.8 ± 5.2 ) min , P < 0.05 ] , the time to two segmental dermatomal regressions and the time to chief complaint of postoperative pain were prolonged significantly[(22.5 ± 4.6 ) , ( 18.5 ± 3.9 ) min vs ( 13.5 ± 3.8 ) min ; ( 415 ± 92 ) , ( 355 ± 86 ) min vs ( 273 ± 68 ) min , P < 0.05 ] , level of sedation and degree of traction reaction were better in RD group and in RF group , and the incidence of shivering was lower in RD group ( 5 % vs 40 % , P < 0.05 ) , the incidence of dizziness was higher in RF group ( 20 % vs 0 , P < 0.05 ) . Compared with RF group , the same results were also seen about the onset time , the time to maximum sensory analgesic level , the time to two segmental dermatomal regressions and the time to chief complaint of postoperative pain , and the level of sedation was better , the incidence of drowsiness was lower in RD group . There were no statistics differences about both the blood gas analysis of umbilical vein and the Apgar scores at 1 and 5 min after delivery . CONCLUSION Administration of dexmedetomidine combined with ropivacaine can provide early onset , establishment of sensory anesthesia , much better sedation levels , decrease the degree of traction reaction and the incidence of shivering , and without adverse neonatal effects
The results showed that , compared with placebo , pethidine , fentanyl , dexmedetomidine , and sufentanil significantly reduced the incidence of perioperative shivering .
In addition , compared with sufentanil , fentanyl showed no impact on haemodynamic stability and the incidence of pruritus .
CONCLUSION Pethidine , fentanyl , dexmedetomidine , and sufentanil appear to be effective for preventing perioperative shivering in puerperae undergoing cesarean sections .
Considering the risk-benefit profiles of the included neuraxial adjuvants , fentanyl is probably the optimal choice
BACKGROUND Perioperative shivering is clinical ly common during cesarean sections under neuraxial anesthesia , and several neuraxial adjuvants are reported to have preventive effects on it .
However , the results of current studies are controversial and the effects of these neuraxial adjuvants remain unclear .
AIM To evaluate the effects of neuraxial adjuvants on perioperative shivering during cesarean sections , thus providing an optimal choice for clinical application .