Intrathecal Dexamethasone and Dexmedetomidine as Adjuncts to Bupivacaine in Elective Cesarean Section: A Case Series

AANA J. 2024 Jun;92(3):207-210.

Abstract

The purpose of this study was to investigate whether the combination of intrathecal dexamethasone and dexmedetomidine in combination with bupivacaine in spinal anesthesia is effective for reducing nausea, vomiting, shivering, and pain. A retrospective review of records was used to examine the outcomes of patients undergoing cesarean delivery under spinal anesthesia with dexamethasone, dexmedetomidine, and bupivacaine. The records of 11 consecutive patients who underwent cesarean delivery under spinal anesthesia with intrathecal dexamethasone and dexmedetomidine in combination with bupivacaine were evaluated. Data collected included patient demographics, medications and fluids administered, presence of nausea, vomiting, shivering, intraoperative breakthrough pain, and postoperative pain. There were no reported complications related to the administration of intrathecal dexamethasone and dexmedetomidine in combination with bupivacaine in this case series of patients. No patients required treatment for intraoperative vomiting, shivering, or breakthrough pain. One patient required opioid pain medication postoperatively. This case series demonstrates that the administration of intrathecal dexamethasone and dexmedetomidine in combination with bupivacaine for patients undergoing elective cesarean section appears to be safe and offers some advantages as to traditional methods of intrathecal delivery for this surgical procedure.

Keywords: bupivacaine; cesarean section; dexamethasone; dexmedetomidine; spinal anesthesia.

MeSH terms

  • Adult
  • Anesthesia, Obstetrical
  • Anesthesia, Spinal*
  • Anesthetics, Local* / administration & dosage
  • Bupivacaine* / administration & dosage
  • Cesarean Section*
  • Dexamethasone* / administration & dosage
  • Dexmedetomidine* / administration & dosage
  • Drug Therapy, Combination
  • Female
  • Humans
  • Injections, Spinal*
  • Nurse Anesthetists
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / prevention & control
  • Postoperative Nausea and Vomiting / chemically induced
  • Postoperative Nausea and Vomiting / prevention & control
  • Pregnancy
  • Retrospective Studies