Dexmedetomidine infusion during caesarean section under general anaesthesia: Evaluation of maternal awareness using BIS, maternal and neonatal outcomes

Study objectives
The present study investigated the effect of dexmedetomidine infusion on bispectral index and hemodynamic values for patients undergoing cesarean section under general anesthesia as well as the postoperative maternal and fetal outcomes.
Design and setting
This is randomized controlled study done in operating rooms and postoperative recovery area.
Patients
44 Adult healthy pregnant females scheduled for elective Caesarian section delivery under general anesthesia were divided randomly in to two equal groups. Dexmedetomidine group and control group.
Interventions
Unlike control group, Dexmedetomidine group: patients were given intravenous loading dose of DEX 1 mcg/kg before induction of anesthesia then intravenous infusion of DEX 0.4 mcg kg hr throughout surgery.
Measurements
The BIS values; heart rate, blood pressure and MAC were monitored at 15 designated points of sequential events during anesthesia. The maternal sedation in the first postoperative hour was reported every 15 min. Apgar score of the neonates was assessed by the pediatrician 1 min and 5 min interval. All patients were asked about awareness or recall at the time of discharge and 6 h after.
Results
BIS values, blood pressure, heart rate and MAC were significantly lower in DEX group at most different time intervals. Both groups of the study were matched as regard as Apgar score at 1 min. and 5 min. Alderete score was significantly lower in DEX group 15 min after extubation. However, both groups were matched 30 min after extubation. Sedation score was higher in Dex group at 5 and 15 min postoperatively. 10 patients in the control group needed extra dose of fentanyl.
Conclusions
Dexmedetomidine is useful adjuvant during general anesthesia for CS as it attenuates hemodynamic responses to surgical stress, reduces needs for analgesic and anesthetic drugs together with favorable maternal and neonatal outcome.