Anesthesia effect of intravenous dexmedetomidine assisting the combined spinal-epidural anesthesia of women during cesar-ean section and its influence on the postoperative rehabilitation
Objective:To investigate the anesthesia effect of intravenous dexmedetomidine assisting the combined spinal-epidural anesthesia of women during cesarean section,and to study its influence on the postoperative rehabilitation of the women.Methods:From January 2021 to December 2023,94 pregnant women who wanted cesarean section were selected and were randomly divided into control group(n=47)and observation group(n=47).The women in the two groups were given the combined spinal-epidural anesthesia during cesarean section.The women in the observation group were given intravenous infusion of dexmedetomidine at a dose of 0.5-1 μg/kg after the fetal delivery until the end of the operation,and the women in the control group were given intravenous infusion of the same amount of 0.9％so-dium chloride injection during the same period.The patient-controlled intravenous analgesia was given to the women in both groups,including dexmedetomidine 2.0 μg/kg,sufentanil 2.0 μg/kg combined with azasetron 0.3 mg/kg in 100ml 0.9％sodium chloride solution for the women in the observation group,and sufentanil 2.0 μg/kg combined with azase-tron 0.3 mg/kg in 100ml 0.9％sodium chloride solution for the women in the control group.The values of the perioperative hemodynamic parameters,the anesthetic effect,the postoperative pain score by VAS and the postopera-tive sedation score by Ramsay of the women were compared between the two groups.The postoperative rehabilitation quality of the women in the two groups evaluated by the postoperative recovery quality scale(QoR-40),the postopera-tive off-bed activity time evaluated by the postpartum depression scale(EPDS).Results:The values of the mean arte-rial pressure,heart rate and oxygen saturation of the women in the two groups immediately after operation were signif-icantly lower than those before pumping dexmedetomidine,but which of the women in the observation group were sig-nificantly higher than those of the women in the control group.The VAS score of the women in the observation group at 12h or 24h after operation(2.70±1.04 points or 1.28±0.83 points)was significantly lower than that(3.32±1.16 points or 2.62±0.87 points)of the women in the control group.The Ramsay scores of the women in the observation group at 2h or 12h after operation(1.83±0.48 points or 2.30±0.55 points)was significantly higher than that(1.60± 0.50 points or 1.94±0.49 points)of the women in the control group.The QoR-40 scores of the women in the observa-tion group at 24h or 48h after operation(125.13±10.70 points or 138.70±10.26 points)was significantly higher than that(112.17±20.06 points or 128.85±10.17 points)of the women in the control group.The time of getting up(8.38 ±0.53h)of the women in the observation group was significantly shorter than that(12.04±1.04h)of the women in the control group.The EPDS scores of the women in the observation group in the 4th weeks and 6th weeks after deliv-ery(5.32±1.08 points and 4.87±0.99 points)were significantly lower than those(6.21±1.08 points and 5.28±0.90 points)of the women in the control group(all P＜0.05).Conclusion:Dexmedetomidine assisting the combined spinal-epidural anesthesia of the women can effectively improve the effect of anesthesia during their cesarean section and im-prove the quality of their postoperative rehabilitation.
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