A comparison of the postoperative analgesic effects of intravenous dexmedetomidine with a combination of dexmedetomidine and bupivacaine wound infiltration for lower segment cesarean section : a prospective, randomized study

الملخص EN

Background and aim This study was designed to compare the postoperative analgesic effect of dexmedetomidine administered intravenously or in wound infi ltration with bupivacaine in patients undergoing cesarean section.

Patients and methods Ninety female patients scheduled for cesarean section were randomly allocated into three equal groups: group I received 100 ml normal saline infusion over 10 min before closure plus wound infi ltration with 25 ml of 0.25% bupivacaine at the end of surgery; group II received 1 μg/kg of dexmedetomidine in 100 ml normal saline infusion over 10 min before closure plus wound infi ltration with 25 ml of 0.25% bupivacaine at the end of surgery; and group III received 100 ml normal saline infusion over 10 min before closure plus wound infi ltration with 1 μg/kg of dexmedetomidine added to 25 ml of 0.25% bupivacaine at the end of surgery.

The number of patients requiring rescue analgesia, total morphine consumption during the fi rst 24 h after the operation, and the level of sedation were recorded.

Results Morphine consumption was signifi cantly less in patients receiving dexmedetomidine by either route.

All patients in group I required supplemental morphine, whereas 14 patients in group II and 16 patients in the wound infi ltration group required supplemental morphine.

Patients in group II had more hypotension and sedation compared with other groups.

Conclusion Dexmedetomidine provided effective postoperative analgesia and reduced morphine consumption when administered intravenously or in wound infi ltration with bupivacaine.

The incidence of complications was less with wound infi ltration.