Effect of dexmedetomidine on shivering and hemodynamics during spinal anesthesia in pregnant and postpartum women

doi:10.11958/20231152

Abstract

Abstract:

Objective To explore the effect of dexmedetomidine on shivering and hemodynamics during spinal anesthesia in pregnant and postpartum women. Methods A total of 384 cases of cesarean section women with shivering during operation admitted to the Fifth Affiliated Hospital of Guangzhou Medical University were selected as the study subjects and randomly divided into the observation group (n=192) and the control group (n=192). The control group was treated with pethidine for chills, while the observation group was treated with dexmedetomidine. For the anesthesia effect, occurrence of chills, the therapeutic effect of shivering treatment, hemodynamic indicators and serum levels of hypersensitive C-reactive protein (hs-CRP), prostaglandin E2 (PGE2) and cortisol (Cor) were compared between two groups. Results Compared to the control group, the observation group had a shorter stopping time for shivering and better control of shivering (P<0.05). Both groups showed changes in hemodynamic indicators such as diastolic blood pressure (DBP), systolic blood pressure (SBP), heart rate (HR) and oxygen saturation (SpO₂), but the fluctuation amplitude of the observation group was significantly smaller than that of the control group (P<0.05). Stress indicators increased in both groups (P<0.05), but levels of hs-CRP, PGE2 and Cor showed a smaller increase in the observation group compared to those of the control group (P<0.05). The total incidence of adverse reactions was lower in the observation group than that in the control group (P<0.05). Conclusion The clinical application of dexmedetomidine for spinal anesthesia has a good effect in the treatment of shivering in cesarean section women, which can stabilize the hemodynamic level of body and has high clinical application value.

Key words: cesarean section, dexmedetomidine, shivering, hemodynamics, hypersensitive C-reactive protein

CLC Number:

R614.3

Figures/Tables 6

References 20

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组别	产妇类型		年龄/ 岁	ASA分级
组别	初产妇	经产妇	年龄/ 岁	Ⅱ级	Ⅲ级
对照组	82（42.7）	110（57.3）	27.15±3.06	127（66.1）	65（33.9）
观察组	90（46.9）	102（53.1）	27.50±3.42	122（63.5）	70（36.5）
χ²或t	0.674		1.054	0.286

组别	产妇类型		年龄/ 岁	ASA分级
组别	初产妇	经产妇	年龄/ 岁	Ⅱ级	Ⅲ级
对照组	82（42.7）	110（57.3）	27.15±3.06	127（66.1）	65（33.9）
观察组	90（46.9）	102（53.1）	27.50±3.42	122（63.5）	70（36.5）
χ²或t	0.674		1.054	0.286

组别	优	良	中	差	优良率/%
对照组	110（57.3）	62（32.3）	18（9.4）	2（1.0）	172（89.6）
观察组	113（58.9）	62（32.3）	16（8.3）	1（0.5）	175（91.1）
χ²					0.269

组别	优	良	中	差	优良率/%
对照组	110（57.3）	62（32.3）	18（9.4）	2（1.0）	172（89.6）
观察组	113（58.9）	62（32.3）	16（8.3）	1（0.5）	175（91.1）
χ²					0.269

组别	寒战停止时间/ min		寒战控制情况
组别	寒战停止时间/ min	消失	缓解	无反应
对照组	5.28±1.26	117（60.9）	75（39.1）	0
观察组	3.61±0.71	154（80.2）	38（19.8）	0
t或χ²	15.998^＊＊		17.167^＊＊