Safe sedation during cesarean section

Authors

  • Yevhenii Hrizhymalskyi Maternity hospital “Leleka”, Kyiv
  • Andrii Harha Maternity hospital “Leleka”, Kyiv, Ukraine

DOI:

https://doi.org/10.31636/prmd.v3i1.7

Keywords:

caesarean section, sedation, dexmedetomidine, neuraxial anaesthesia

Abstract

With increasing maternal age caesarean section rates increase every year. Neuraxial anaesthesia is a method of choice for caesarean section; wide implementation of it has resulted in the reduction of maternal mortality from anaesthesia complications. Neuraxial anaesthesia also lets the patient remain conscious during birth as well as actively participate in the delivery. On the other hand, levels of stress and anxiety are higher compared to vaginal birth, consequently, in a few cases, sedation is needed. There is described a lot of sedation methods including using nitrous oxide, propofol, benzodiazepines, opioids, and dexmedetomidine. Considering the results of studies published in contemporary literature, safe sedation can be provided, even prior to the beginning of cesarean section and anaesthesia.

Downloads

Download data is not yet available.

References

Rollins M, Lucero J. Overview of anesthetic considerations for Cesarean delivery. British Medical Bulletin [Internet]. Oxford University Press (OUP); 2012 Jan 4;101(1):105–25. Available from: https://doi.org/10.1093/bmb/ldr050

Carrie les. Extradural, spinal or combined block for obstetric surgical anaesthesia. British Journal of Anaesthesia [Internet]. Elsevier BV; 1990 Aug;65(2):225–33. Available from: https://doi.org/10.1093/bja/65.2.225

Marucci M, Diele C, Bruno F, Fiore T. Subarachnoid anaesthesia in caesarean delivery: effects on alertness. Minerva anestesiologica. 2003 Nov;69(11):809-24.

Danielak-Nowak M, Musioł E, Arct-Danielak D, Duda I, Ludwik K. A comparison of subhypnotic doses of propofol and midazolam during spinal anaesthesia for elective Caesarean section. Anestezjologia Intensywna Terapia [Internet]. Termedia Sp. z.o.o.; 2016 Mar 11;48(1):13–8. Available from: https://doi.org/10.5603/ait.2016.0003

Vaida S, Cattano D, Hurwitz D, Mets B. Algorithm for the anesthetic management of cesarean delivery in patients with unsatisfactory labor epidural analgesia. F1000Research [Internet]. F1000 Research Ltd; 2015 Apr 24;4:98. Available from: https://doi.org/10.12688/f1000research.6381.1

Mazy A, Madkour N, Shaalan H. Can propofol procedural sedation implementation increase the acceptance of spinal anesthesia during cesarean section? Ain-Shams Journal of Anesthesiology [Internet]. Springer Science and Business Media LLC; 2019 Dec;11(1). Available from: https://doi.org/10.1186/s42077-019-0043-9

Ghiasi A, Keramat A. The effect of listening to holy quran recitation on anxiety: A systematic review. Iranian Journal of Nursing and Midwifery Research [Internet]. Medknow; 2018;23(6):411. Available from: https://doi.org/10.4103/ijnmr.ijnmr_173_17

Faruki A, Nguyen T, Proeschel S, Levy N, Yu J, Ip V, et al. Virtual reality as an adjunct to anesthesia in the operating room. Trials [Internet]. Springer Science and Business Media LLC; 2019 Dec;20(1). Available from: https://doi.org/10.1186/s13063-019-3922-2

Wang C, Liu S, Han C, Yu M, Hu Y, Liu C. Effect and placental transfer of dexmedetomidine during caesarean section under epidural anaesthesia. Journal of International Medical Research [Internet]. SAGE Publications; 2017 Apr 28;45(3):964–72. Available from: https://doi.org/10.1177/0300060517698330

Bavaro JB, Mendoza JL, McCarthy RJ, Toledo P, Bauchat JR. Maternal sedation during scheduled versus unscheduled cesarean delivery: implications for skin-to-skin contact. International Journal of Obstetric Anesthesia [Internet]. Elsevier BV; 2016 Aug;27:17–24. Available from: https://doi.org/10.1016/j.ijoa.2016.06.003

Pollock JE, Neal JM, Liu SS, Burkhead D, Polissar N. Sedation during Spinal Anesthesia. Anesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 2000 Sep;93(3):728–34. Available from: https://doi.org/10.1097/00000542-200009000-00022

Yegin A, Sanli S, Dosemeci L, Kayacan N, Akbas M, Karsli B. The analgesic and sedative effects of intrathecal midazolam in perianal surgery. European Journal of Anaesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 2004 Aug;21(8):658–62. Available from: https://doi.org/10.1097/00003643-200408000-00012

Kaya FN, Sahin S, Owen MD, Eisenach JC. Epidural Neostigmine Produces Analgesia but Also Sedation in Women after Cesarean Delivery. Anesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 2004 Feb;100(2):381–5. Available from: https://doi.org/10.1097/00000542-200402000-00030

Elzayyat N, Ahmed Nagy H, Girgis K. Comparing the effect of adding dexmedetomidine versus dexamethasone on prolonging the duration of intrathecal bupivacaine in lower abdominal operations. Ain-Shams Journal of Anaesthesiology [Internet]. Medknow; 2014;7(3):388. Available from: https://doi.org/10.4103/1687-7934.139574

Barnardo PD, Jenkins JG. Failed tracheal intubation in obstetrics: a 6-year review in a UK region. Anaesthesia [Internet]. Wiley; 2000 Jul;55(7):690–4. Available from: https://doi.org/10.1046/j.1365-2044.2000.01536.x

CPSychol TN. Sedation scales and measures-a literature review. SAAD digest. 2013 Jan;29:88.

Manouchehrian N, Bakhshaei MH. Nitrous Oxide Effect on Relieving Anxiety and Pain in Parturients Under Spinal Anesthesia for Caesarean Section. Anesthesiology and Pain Medicine [Internet]. Kowsar Medical Institute; 2014 May 26;4(2). Available from: https://doi.org/10.5812/aapm.16662

Vallejo MC, Phelps AL, Shepherd CJ, Kaul B, Mandell GL, Ramanathan S. Nitrous oxide anxiolysis for elective cesarean section. Journal of Clinical Anesthesia [Internet]. Elsevier BV; 2005 Nov;17(7):543–8. Available from: https://doi.org/10.1016/j.jclinane.2005.01.009

Buhre W, Disma N, Hendrickx J, DeHert S, Hollmann MW, Huhn R, et al. European Society of Anaesthesiology Task Force on Nitrous Oxide: a narrative review of its role in clinical practice. British Journal of Anaesthesia [Internet]. Elsevier BV; 2019 May;122(5):587–604. Available from: https://doi.org/10.1016/j.bja.2019.01.023

Mazy A, Madkour N, Shaalan H. Can propofol procedural sedation implementation increase the acceptance of spinal anesthesia during cesarean section? Ain-Shams Journal of Anesthesiology [Internet]. Springer Science and Business Media LLC; 2019 Dec;11(1). Available from: https://doi.org/10.1186/s42077-019-0043-9

Frölich M, Burchfield DJ, Euliano T, Caton D. A single dose of fentanyl and midazolam prior to Cesarean section have no adverse neontal effects. Canadian Journal of Anesthesia/Journal canadien d’anesthésie [Internet]. Springer Science and Business Media LLC; 2006 Jan;53(S1):79–85. Available from: https://doi.org/10.1007/bf03021531

Afonso J, Reis F. Dexmedetomidine: Current Role in Anesthesia and Intensive Care. Brazilian Journal of Anesthesiology [Internet]. Elsevier BV; 2012 Jan;62(1):118–33. Available from: https://doi.org/10.1016/s0034-7094(12)70110-1

Nair A, Sriprakash K. Dexmedetomidine in pregnancy: Review of literature and possible use. Journal of Obstetric Anaesthesia and Critical Care [Internet]. Medknow; 2013;3(1):3. Available from: https://doi.org/10.4103/2249-4472.114253

Neumann MM, Davio MB, Macknet MR, Applegate RL. Dexmedetomidine for Awake Fiberoptic Intubation in a Parturient With Spinal Muscular Atrophy Type III for Cesarean Delivery. Obstetric Anesthesia Digest [Internet]. Ovid Technologies (Wolters Kluwer Health); 2010 Dec;30(4):246. Available from: https://doi.org/10.1097/01.aoa.0000389626.41532.84

Palanisamy A, Klickovich RJ, Ramsay M, Ouyang DW, Tsen LC. Intravenous dexmedetomidine as an adjunct for labor analgesia and cesarean delivery anesthesia in a parturient with a tethered spinal cord. International Journal of Obstetric Anesthesia [Internet]. Elsevier BV; 2009 Jul;18(3):258–61. Available from: https://doi.org/10.1016/j.ijoa.2008.10.002

Abu-Halaweh SA, Al Oweidi A-KS, Abu-Malooh H, Zabalawi M, Alkazaleh F, Abu-Ali H, et al. Intravenous dexmedetomidine infusion for labour analgesia in patient with preeclampsia. European Journal of Anaesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 2009 Jan;26(1):86–7. Available from: https://doi.org/10.1097/eja.0b000e000000f3fb

Jiang W, Wang Q, Xu M, Li Y, Yang R, Song X, et al. Assessment of different loading doses of dexmedetomidine hydrochloride in preventing adverse reaction after combined spinal-epidural anesthesia. Experimental and Therapeutic Medicine [Internet]. Spandidos Publications; 2017 Apr 13;13(6):2946–50. Available from: https://doi.org/10.3892/etm.2017.4335

Wang J, Han Z, Zhou H, Wang N, Ma H. Effective Loading Dose of Dexmedetomidine to Induce Adequate Sedation in Parturients Undergoing Caesarean Section Under Spinal Anaesthesia. Turkish Journal of Anesthesia and Reanimation [Internet]. AVES Publishing Co.; 2017 Oct 23;45(5):260–3. Available from: https://doi.org/10.5152/tjar.2017.04578

Cortegiani A, Accurso G, Gregoretti C. Should We Use Dexmedetomidine for Sedation in Parturients Undergoing Caesarean Section Under Spinal Anaesthesia? Turkish Journal of Anesthesia and Reanimation [Internet]. AVES Publishing Co.; 2017 Oct 23;45(5):249–50. Available from: https://doi.org/10.5152/tjar.2017.0457812

Salah D, Sayed W, Adib F. Studying the sedative effect of dexmedetomidine administered by two different routes, a randomized comparative trial. Ain-Shams Journal of Anaesthesiology [Internet]. Medknow; 2016;9(2):240. Available from: https://doi.org/10.4103/1687-7934.179901

Wang YQ, Zhang X-J, Wang Y. Effect of intrathecal dexmedetomidine on cesarean section during spinal anesthesia: a meta-analysis of randomized trials. Drug Design, Development and Therapy [Internet]. Informa UK Limited; 2019 Aug;Volume 13:2933–9. Available from: https://doi.org/10.2147/dddt.s207812

Liu L, Qian J, Shen B, Xiao F, Shen H. Intrathecal dexmedetomidine can decrease the 95% effective dose of bupivacaine in spinal anesthesia for cesarean section. Medicine [Internet]. Ovid Technologies (Wolters Kluwer Health); 2019 Mar;98(9):e14666. Available from: https://doi.org/10.1097/md.0000000000014666

 Безпечна седація під час кесаревого розтину

Published

2020-06-01

How to Cite

1.
Hrizhymalskyi Y, Harha A. Safe sedation during cesarean section. prmd [Internet]. 2020Jun.1 [cited 2020Oct.25];3(1):40-5. Available from: https://perioperative.org.ua/index.php/prtmdc/article/view/45