• Minghao Liu, Bin Wang, Bizimana Prudence, and Xuezi Chen.
• Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, People's Republic of China.
• J Anesth. 2023 Jun 1; 37 (3): 371378371-378.

PurposeThis study aimed to evaluate the effect of different doses of epidural dexmedetomidine on reducing visceral traction reaction for cesarean section under epidural anesthesia.MethodsNulliparas were randomly allocated to receive epidural ropivacaine alone (group R) or in combination with dexmedetomidine 0.5 μg/kg (group RD0.5), 0.75 μg/kg (group RD0.75), and 1 μg/kg (group RD1) with 46 nulliparas in each group. The primary outcome was intraoperative visceral traction reaction (graded from 0 to 3, with 0 and 3, respectively, regarded as 'no discomfort in stomach or perineum; no nausea, vomiting or intestinal tympanites' and 'serious visceral pain, nausea and vomiting, intestinal tympanites').ResultsVisceral traction reaction was significantly alleviated in group RD0.5, RD0.75, and RD1, respectively, compared to group R while it was comparable among RD groups. Increased Ramsay Sedation Scale and lower incidence of shivering were found in RD groups compared to group R (p < 0.001). None of the primipara has experienced Ramsay Sedation Scale above 4. Higher incidence of thirst was found in group RD0.75 and RD1 compared to group R and RD0.5 (p < 0.001). The Apgar scores at 1 and 5 min of the neonates, onset time to T6 sensory block, maximum sensory block level, the incidence of hypotension, bradycardia and nausea or vomiting were comparable among groups.ConclusionIt is suggested that 0.5 μg/kg epidural dexmedetomidine can be used as adjuvant to epidural ropivacaine during cesarean section, because of its alleviating visceral traction reaction, moderate sedating, and reducing shivering without thirst increase.© 2023. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.

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