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Intravenous Dexmedetomidine for Cesarean Section

Phase 4
Completed
Conditions
Breast Feeding
Analgesia Obstetrical
Postoperative Pain
Interventions
Registration Number
NCT03065530
Lead Sponsor
The First Affiliated Hospital with Nanjing Medical University
Brief Summary

Nervous, anxiety, fear and other psychological reactions always appears in parturients during cesarean section. This study intends to investigate the effectiveness and safety of dexmedetomidine combined with butorphanol tartrate for postoperative analgesia and breastfeeding after caesarean section.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
120
Inclusion Criteria
  1. Parturients who had successfully breastfed a prior infant and planned to breastfeed after this delivery were screened for eligibility.
  2. Parturients undergoing elective caesarean delivery under epidural anaesthesia
  3. ASA I and II parturients aged 18-45 years, with singleton gestation.
  4. Parturients with verbal and written mandarin
  5. Parturients who want to use PCA intravenous analgesia and can use the pump correctly
  6. written informed consent.

Exclusion Criteria

  1. Multiple gestation.
  2. A history of allergy to dexmedetomidine or other study drugs
  3. Cardiovascular disease (basic HR<50bpm or SBP<100mmHg)
  4. Opioid drugs abuse.
  5. BMI more than 35 kg/m2
  6. Conditions that preclude spinal anesthesia.
  7. Preeclampsia or epilepsy.
  8. A history of neuromuscular disease.
  9. Epidural anaesthesia was unsuccessful.
  10. The parturients, whose surgery ended after 11 a.m.
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
control groupNormal SalineThe placebo group will pumped in the same volume of saline 0.9% as calculated by parturients' weight in 30 min and receive 1mg butorphanol after delivery. Postoperative analgesic formula: 3ug/kg/h butorphanol tartrate, diluted with normal saline to 100ml. Background dose: 2ml/h, PCA: 0.5ml, locking time: 15 min.
Dexmedetomidine 0.03ug/kg/h groupDexmedetomidine 0.03ug/kg/hThis group will receive 0.5ug/kg intravenous dexmedetomidine diluted to 4ug/ml in 30 min and 1mg butorphanol tartrate after delivery. Postoperative analgesic formula: 3ug/kg/h butorphanol tartrate with 0.03ug/kg/h dexmedetomidine, diluted with normal saline to 100ml. Background dose: 2ml/h, PCA: 0.5ml, locking time: 15 min.
Dexmedetomidine 0.08ug/kg/h groupDexmedetomidine 0.08ug/kg/hThis group will receive 0.5ug/kg intravenous dexmedetomidine diluted to 4ug/ml in 30 min and 1mg butorphanol tartrate after delivery. Postoperative analgesic formula: 3ug/kg/h butorphanol tartrate with 0.08ug/kg/h dexmedetomidine, diluted with normal saline to 100ml. Background dose: 2ml/h, PCA: 0.5ml, locking time: 15 min.
Dexmedetomidine 0.05ug/kg/h groupDexmedetomidine 0.05ug/kg/hThis group will receive 0.5ug/kg intravenous dexmedetomidine diluted to 4ug/ml in 30 min and 1mg butorphanol tartrate after delivery. Postoperative analgesic formula: 3ug/kg/h butorphanol tartrate with 0.05ug/kg/h dexmedetomidine, diluted with normal saline to 100ml. Background dose: 2ml/h, PCA: 0.5ml, locking time: 15 min.
Primary Outcome Measures
NameTimeMethod
Postoperative Pain Score (Visual Analogue Scale, VAS) at Rest6h after cesarean section.

visual analogue scale (VAS; with 0, no pain; to 10, the worst imaginable pain) is a validated assessing scale for pain intensity. VAS at rest was assessed when the patient was in supine position

Secondary Outcome Measures
NameTimeMethod
Postoperative Pain Score (Visual Analogue Scale, VAS) on Uterine Cramping24h after cesarean section.

visual analogue scale (VAS; with 0, no pain; to 10, the worst imaginable pain) is a validated assessing scale for pain intensity. VAS-C was assessed when the patient required oxytocin after surgery in supine position

Relative Infant Dose (RID) of Dexmedetomidine48h after cesarean section.

Relative infant dose (RID) =Dose (infant, mg•kg-1•day-1) /Dose (mother, mg•kg-1•day-1) μg·kg-1·h-1. The Dose (infant) in mg•kg-1 is calculated by multiplying the concentration of the drug in breast milk by the volume of breast milk consumed daily (about 150 mL•kg-1).

Postoperative Pain Score (Visual Analogue Scale, VAS) at Rest24h after cesarean section.

visual analogue scale (VAS; with 0, no pain; to 10, the worst imaginable pain) is a validated assessing scale for pain intensity. VAS at rest was assessed when the patient was in supine position

Ramsay Sedation Score(RSS)48h after cesarean section.

Sedation intensity measured with RSS is recorded at the 6, 12, 24, and 48 h after cesarean section. Sedation was assessed by the Ramsay Sedation Scores (RSS) (1, anxious patient; 2, cooperative and tranquil; 3, responding to command; 4, brisk response to stimulus; 5, sluggish response to stimulus; 6, no response to stimulus).

The Degree of Satisfaction48h after cesarean section.

The degree of satisfaction (0, very satisfied; 1, satisfied; 2, moderately satisfied; 3, not satisfied) was evaluated at 48 h after surgery. The number of overall satisfied patients (satisfied and very satisfied) is reported.

Number of Participants That Experienced Nausea or Vomiting48h after cesarean section.

Total times during 48h after cesarean section.

Postoperative Pain Score (Visual Analogue Scale, VAS)48h after cesarean section.

visual analogue scale (VAS; with 0, no pain; to 10, the worst imaginable pain) is a validated assessing scale for pain intensity. VAS at rest was assessed when the patient was in supine position

Postoperative Pain Score (Visual Analogue Scale, VAS) on Movement48h after cesarean section.

visual analogue scale (VAS; with 0, no pain; to 10, the worst imaginable pain) is a validated assessing scale for pain intensity. VAS on movement was assessed when patients changed from supine to lateral position.

Trial Locations

Locations (1)

The First Affiliated Hospital with Nanjing Medical University

🇨🇳

Nanjing, Jiangsu, China

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