The Effectiveness and Safety of Ropivacaine and Medium-Dose Dexmedetomidine in Cesarean Section

Abstract

Objective: To study the effects of epidural anesthesia with different doses of dexmedetomidine and ropivacaine on postoperative hemodynamics and neonatal outcome of cesarean section parturients. Methods. A total of 90 parturients who underwent cesarean section admitted to our hospital from January 2019 to January 2020 were selected as the research objects and were divided into groups A, B, and C according to different dosages of dexmedetomidine, with 30 cases in each group. Groups A, B, and C were given dexmedetomidine 0.5 μg/kg, 0.8 μg/kg, 1.0 μg/kg, respectively, combined with 0.2% ropivacaine. The anesthesia effect, traction response, hemodynamic indexes, and neonatal Apgar score of the three groups were compared; the "Numerical Rating Scale (NRS) Score" was used to assess the postoperative pain of the parturients, and the "Ramsay Sedation Scale" was used to assess the sedation state of the parturients. Results. The superior anesthesia effect of group B was obtained compared with groups A and C (P < 0.05). Group B witnessed a lower degree of grade III stretching response, as compared to group A (P < 0.05). In comparison with groups A and C, superior results of the heart rate and mean artery pressure (MAP) of group B at T1 and T2 were obtained (P < 0.05). The neonatal Apgar score in group B was lower than those in groups A and C (P < 0.05), and the NRS score of group B was also lower than that of group A (P < 0.05). Compared with groups A and C, group B yielded a more favorable outcome in terms of the Ramsay score (P < 0.05). Conclusion. The use of medium-dose dexmedetomidine in cesarean section parturients is safer and can effectively reduce the impact on maternal hemodynamics, which is worthy of promotion and application.

Figure 1

Comparison of the HR of the three groups at different time points (x ± s). The abscissa represented time of T0, T1, and T2, and the ordinate represented heart rate (times/min). ^∗indicates that there was a significant difference in the heart rate of the three groups at T1 (t = 4.784, P=0.002); ^∗∗indicates that there was a significant difference in the heart rate of the three groups at T1 (t = 4.245, P=0.006).

Figure 2

Comparison of MAP indexes of the three groups at different time points (x ± s). The abscissa represented time of T0, T1, and T2, and the ordinate represented the MAP index (mmHg). ^∗indicates that there was a significant difference in the MAP index of the three groups at T1 (t = 3.662, P=0.012); ^∗∗indicates that there was a significant difference in the MAP index of the three groups at T2 (t = 3.650, P=0.013).

Figure 3

Comparison of the Apgar score of the three groups (x ± s). The abscissa represented groups A, B, and C, and the ordinate represented the Apgar score (points). ^∗indicates that there was a significant difference in the Apgar score between groups A and B (t = 2.818, P=0.007); ^∗∗indicates that there was a significant difference in the Apgar score between groups B and C (t = 3.385, P=0.001).

Figure 4

Comparison of the NRS score of the three groups (x ± s). The abscissa represented after operation, and the ordinate represented the NRS score (points). ^∗indicates that there was a significant difference in the NRS score between groups A and B (t = 9,966, P < 0.001); ^∗∗indicates that there was a significant difference in the NRS score between groups A and C (t = 11.341, P < 0.001).

Figure 5

Comparison of the Ramsay score of the three groups (x ± s). The abscissa represented after operation, and the ordinate represented the Ramsay score (points). ^∗indicates that there was a significant difference in the Ramsay score between groups A and B (t = 10.578, P < 0.001); ^∗∗indicates that there was a significant difference in the NRS score between groups B and C (t = 10.084, P < 0.001).