Effect of Dexmedetomidine Combined with Spinal-Epidural Anesthesia on Analgesia, Postoperative Sleep and Incidence of Depression in Parturients with Cesarean Section
HUANG Wei, WANG Tingting
Department of Anesthesiology, Changning Maternal and Child Health Hospital, Shanghai 200050
Abstract 【Objective】This study aims to explore the analgesic effects of Dexmedetomidine (Dex) combined with Spinal-Epidural Anesthesia (CSEA) on analgesia, postoperative sleep quality and risk of depression during cesarean delivery. 【Methods】Seventy parturients undergoing cesarean section were randomly divided into the observation group and the control group, with 35 subjects in each group. The control group received CSEA, and the observation group received Dex in addition to CSEA. The sedation score (Ramsay), visual analog scale (VAS) for pain, preoperative and postoperative sleep quality, depression scores, hemodynamics, adverse reactions, and neonatal Apgar scores were compared between the groups. 【Results】Post-anesthesia Ramsay scores in both groups were higher immediately after anesthesia; And the 24-hour postoperative VAS scores were higher than those at 1-hour post-surgery (P<0.05). The observation group showed higher post-anesthesia Ramsay scores and lower 24-hour postoperative VAS scores compared to the control group (P<0.05). Postoperative Athens Insomnia Scale (AIS) scores in both groups were higher than those preoperative scores, and postoperative Self-Rating Depression Scale (SDS) scores were lower than those preoperative scores in both groups (P<0.05), with the observation group showing lower postoperative AIS and SDS scores than the control group (P<0.05). The observation group's neonatal respiratory, heart rate, and skin color scores were significantly higher than those in the control group (P<0.05), while there were no significant differences in muscle tone and laryngeal reflex scores between the groups (P>0.05). There was no significant difference in postoperative oxygen saturation (SpO2) levels between the groups (P>0.05), however, the heart rate (HR) and mean arterial pressure (MAP) were significantly lower postoperatively than preoperatively (P<0.05), with higher postoperative HR and MAP levels in the observation group (P<0.05). The overall incidence of adverse reactions was significantly lower in the observation group (P<0.05). 【Conclusion】The use of Dex combined with CSEA for cesarean delivery significantly enhances analgesia and sedation with effectively reducing pain, improving sleep quality, and alleviating depressive symptoms, It is worthy of clinical application.
HUANG Wei,WANG Tingting. Effect of Dexmedetomidine Combined with Spinal-Epidural Anesthesia on Analgesia, Postoperative Sleep and Incidence of Depression in Parturients with Cesarean Section[J]. JOURNAL OF CLINICAL RESEARCH, 2024, 41(8): 1171-1174.