Intravenous Dexmedetomidine for Cesarean Section

NCT ID: NCT03065530

Last Updated: 2020-01-13

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-02-07

Study Completion Date

2017-10-05

Brief Summary

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Nervous, anxiety, fear and other psychological reactions always appears in parturients during cesarean section. This study intends to investigate the effectiveness and safety of dexmedetomidine combined with butorphanol tartrate for postoperative analgesia and breastfeeding after caesarean section.

Detailed Description

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Conditions

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Breast Feeding Analgesia Obstetrical Postoperative Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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control group

The placebo group will pumped in the same volume of saline 0.9% as calculated by parturients' weight in 30 min and receive 1mg butorphanol after delivery.

Postoperative analgesic formula: 3ug/kg/h butorphanol tartrate, diluted with normal saline to 100ml. Background dose: 2ml/h, PCA: 0.5ml, locking time: 15 min.

Group Type PLACEBO_COMPARATOR

Normal Saline

Intervention Type DRUG

Drug: Normal saline control group receive NS after delivery. Drug: butorphanol tartrate PCA: butorphanol tartrate after cesarean section.

Dexmedetomidine 0.03ug/kg/h group

This group will receive 0.5ug/kg intravenous dexmedetomidine diluted to 4ug/ml in 30 min and 1mg butorphanol tartrate after delivery.

Postoperative analgesic formula: 3ug/kg/h butorphanol tartrate with 0.03ug/kg/h dexmedetomidine, diluted with normal saline to 100ml. Background dose: 2ml/h, PCA: 0.5ml, locking time: 15 min.

Group Type EXPERIMENTAL

Dexmedetomidine 0.03ug/kg/h

Intervention Type DRUG

Drug: Dexmedetomidine This group receive Dex 0.5ug/kg after delivery. Drug: butorphanol tartrate and Dexmedetomidine. PCA: butorphanol tartrate with 0.03ug/kg/h Dexmedetomidine after cesarean section.

Dexmedetomidine 0.05ug/kg/h group

This group will receive 0.5ug/kg intravenous dexmedetomidine diluted to 4ug/ml in 30 min and 1mg butorphanol tartrate after delivery.

Postoperative analgesic formula: 3ug/kg/h butorphanol tartrate with 0.05ug/kg/h dexmedetomidine, diluted with normal saline to 100ml. Background dose: 2ml/h, PCA: 0.5ml, locking time: 15 min.

Group Type EXPERIMENTAL

Dexmedetomidine 0.05ug/kg/h

Intervention Type DRUG

Drug: Dexmedetomidine This group receive Dex 0.5ug/kg after delivery. Drug: butorphanol tartrate and Dexmedetomidine. PCA: butorphanol tartrate with 0.05ug/kg/h Dexmedetomidine after cesarean section.

Dexmedetomidine 0.08ug/kg/h group

This group will receive 0.5ug/kg intravenous dexmedetomidine diluted to 4ug/ml in 30 min and 1mg butorphanol tartrate after delivery.

Postoperative analgesic formula: 3ug/kg/h butorphanol tartrate with 0.08ug/kg/h dexmedetomidine, diluted with normal saline to 100ml. Background dose: 2ml/h, PCA: 0.5ml, locking time: 15 min.

Group Type EXPERIMENTAL

Dexmedetomidine 0.08ug/kg/h

Intervention Type DRUG

Drug: Dexmedetomidine This group receive Dex 0.5ug/kg after delivery. Drug: butorphanol tartrate and Dexmedetomidine. PCA: butorphanol tartrate with 0.08ug/kg/h Dexmedetomidine after cesarean section.

Interventions

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Normal Saline

Drug: Normal saline control group receive NS after delivery. Drug: butorphanol tartrate PCA: butorphanol tartrate after cesarean section.

Intervention Type DRUG

Dexmedetomidine 0.03ug/kg/h

Drug: Dexmedetomidine This group receive Dex 0.5ug/kg after delivery. Drug: butorphanol tartrate and Dexmedetomidine. PCA: butorphanol tartrate with 0.03ug/kg/h Dexmedetomidine after cesarean section.

Intervention Type DRUG

Dexmedetomidine 0.05ug/kg/h

Drug: Dexmedetomidine This group receive Dex 0.5ug/kg after delivery. Drug: butorphanol tartrate and Dexmedetomidine. PCA: butorphanol tartrate with 0.05ug/kg/h Dexmedetomidine after cesarean section.

Intervention Type DRUG

Dexmedetomidine 0.08ug/kg/h

Drug: Dexmedetomidine This group receive Dex 0.5ug/kg after delivery. Drug: butorphanol tartrate and Dexmedetomidine. PCA: butorphanol tartrate with 0.08ug/kg/h Dexmedetomidine after cesarean section.

Intervention Type DRUG

Other Intervention Names

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dexmedetomidine Injection Dexmedetomidine Hydrochloride dexmedetomidine Injection Dexmedetomidine Hydrochloride dexmedetomidine Injection Dexmedetomidine Hydrochloride

Eligibility Criteria

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Inclusion Criteria

1. Parturients who had successfully breastfed a prior infant and planned to breastfeed after this delivery were screened for eligibility.
2. Parturients undergoing elective caesarean delivery under epidural anaesthesia
3. ASA I and II parturients aged 18-45 years, with singleton gestation.
4. Parturients with verbal and written mandarin
5. Parturients who want to use PCA intravenous analgesia and can use the pump correctly
6. written informed consent.

Exclusion Criteria

1. Multiple gestation.
2. A history of allergy to dexmedetomidine or other study drugs
3. Cardiovascular disease (basic HR\<50bpm or SBP\<100mmHg)
4. Opioid drugs abuse.
5. BMI more than 35 kg/m2
6. Conditions that preclude spinal anesthesia.
7. Preeclampsia or epilepsy.
8. A history of neuromuscular disease.
9. Epidural anaesthesia was unsuccessful.
10. The parturients, whose surgery ended after 11 a.m.
Minimum Eligible Age

24 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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The First Affiliated Hospital with Nanjing Medical University

OTHER

Sponsor Role lead

Responsible Party

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Shijiang Liu

Attending

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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The First Affiliated Hospital with Nanjing Medical University

Nanjing, Jiangsu, China

Site Status

Countries

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China

References

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Desborough JP. The stress response to trauma and surgery. Br J Anaesth. 2000 Jul;85(1):109-17. doi: 10.1093/bja/85.1.109. No abstract available.

Reference Type RESULT
PMID: 10927999 (View on PubMed)

Perkins FM, Kehlet H. Chronic pain as an outcome of surgery. A review of predictive factors. Anesthesiology. 2000 Oct;93(4):1123-33. doi: 10.1097/00000542-200010000-00038. No abstract available.

Reference Type RESULT
PMID: 11020770 (View on PubMed)

Kainu JP, Halmesmaki E, Korttila KT, Sarvela PJ. Persistent Pain After Cesarean Delivery and Vaginal Delivery: A Prospective Cohort Study. Anesth Analg. 2016 Dec;123(6):1535-1545. doi: 10.1213/ANE.0000000000001619.

Reference Type RESULT
PMID: 27870738 (View on PubMed)

Eisenach JC, Pan PH, Smiley R, Lavand'homme P, Landau R, Houle TT. Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain. 2008 Nov 15;140(1):87-94. doi: 10.1016/j.pain.2008.07.011. Epub 2008 Sep 24.

Reference Type RESULT
PMID: 18818022 (View on PubMed)

Lin TF, Yeh YC, Lin FS, Wang YP, Lin CJ, Sun WZ, Fan SZ. Effect of combining dexmedetomidine and morphine for intravenous patient-controlled analgesia. Br J Anaesth. 2009 Jan;102(1):117-22. doi: 10.1093/bja/aen320. Epub 2008 Nov 5.

Reference Type RESULT
PMID: 18987053 (View on PubMed)

Jakob SM, Ruokonen E, Grounds RM, Sarapohja T, Garratt C, Pocock SJ, Bratty JR, Takala J; Dexmedetomidine for Long-Term Sedation Investigators. Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. JAMA. 2012 Mar 21;307(11):1151-60. doi: 10.1001/jama.2012.304.

Reference Type RESULT
PMID: 22436955 (View on PubMed)

Schnabel A, Meyer-Friessem CH, Reichl SU, Zahn PK, Pogatzki-Zahn EM. Is intraoperative dexmedetomidine a new option for postoperative pain treatment? A meta-analysis of randomized controlled trials. Pain. 2013 Jul;154(7):1140-9. doi: 10.1016/j.pain.2013.03.029. Epub 2013 Mar 27.

Reference Type RESULT
PMID: 23706726 (View on PubMed)

Colin PJ, Hannivoort LN, Eleveld DJ, Reyntjens KMEM, Absalom AR, Vereecke HEM, Struys MMRF. Dexmedetomidine pharmacokinetic-pharmacodynamic modelling in healthy volunteers: 1. Influence of arousal on bispectral index and sedation. Br J Anaesth. 2017 Aug 1;119(2):200-210. doi: 10.1093/bja/aex085.

Reference Type RESULT
PMID: 28854538 (View on PubMed)

Arain SR, Ruehlow RM, Uhrich TD, Ebert TJ. The efficacy of dexmedetomidine versus morphine for postoperative analgesia after major inpatient surgery. Anesth Analg. 2004 Jan;98(1):153-158. doi: 10.1213/01.ANE.0000093225.39866.75.

Reference Type RESULT
PMID: 14693611 (View on PubMed)

Ren C, Chi M, Zhang Y, Zhang Z, Qi F, Liu Z. Dexmedetomidine in Postoperative Analgesia in Patients Undergoing Hysterectomy: A CONSORT-Prospective, Randomized, Controlled Trial. Medicine (Baltimore). 2015 Aug;94(32):e1348. doi: 10.1097/MD.0000000000001348.

Reference Type RESULT
PMID: 26266386 (View on PubMed)

Orbach-Zinger S, Fireman S, Ben-Haroush A, Karoush T, Klein Z, Mazarib N, Artyukh A, Chen R, Ioscovich A, Eidelman LA, Landau R. Preoperative sleep quality predicts postoperative pain after planned caesarean delivery. Eur J Pain. 2017 May;21(5):787-794. doi: 10.1002/ejp.980. Epub 2016 Dec 15.

Reference Type RESULT
PMID: 27977073 (View on PubMed)

Hsu YW, Cortinez LI, Robertson KM, Keifer JC, Sum-Ping ST, Moretti EW, Young CC, Wright DR, Macleod DB, Somma J. Dexmedetomidine pharmacodynamics: part I: crossover comparison of the respiratory effects of dexmedetomidine and remifentanil in healthy volunteers. Anesthesiology. 2004 Nov;101(5):1066-76. doi: 10.1097/00000542-200411000-00005.

Reference Type RESULT
PMID: 15505441 (View on PubMed)

El-Tahan MR, Mowafi HA, Al Sheikh IH, Khidr AM, Al-Juhaiman RA. Efficacy of dexmedetomidine in suppressing cardiovascular and hormonal responses to general anaesthesia for caesarean delivery: a dose-response study. Int J Obstet Anesth. 2012 Jul;21(3):222-9. doi: 10.1016/j.ijoa.2012.04.006. Epub 2012 Jun 7.

Reference Type RESULT
PMID: 22681971 (View on PubMed)

Nie Y, Liu Y, Luo Q, Huang S. Effect of dexmedetomidine combined with sufentanil for post-caesarean section intravenous analgesia: a randomised, placebo-controlled study. Eur J Anaesthesiol. 2014 Apr;31(4):197-203. doi: 10.1097/EJA.0000000000000011.

Reference Type RESULT
PMID: 24463478 (View on PubMed)

Sia AT, Sng BL. Intravenous dexmedetomidine for obstetric anaesthesia and analgesia: converting a challenge into an opportunity? Int J Obstet Anesth. 2009 Jul;18(3):204-6. doi: 10.1016/j.ijoa.2009.02.008. Epub 2009 May 22. No abstract available.

Reference Type RESULT
PMID: 19464877 (View on PubMed)

Abu-Halaweh SA, Al Oweidi AK, Abu-Malooh H, Zabalawi M, Alkazaleh F, Abu-Ali H, Ramsay MA. Intravenous dexmedetomidine infusion for labour analgesia in patient with preeclampsia. Eur J Anaesthesiol. 2009 Jan;26(1):86-7. doi: 10.1097/EJA.0b000e000000f3fb. No abstract available.

Reference Type RESULT
PMID: 19122562 (View on PubMed)

Nakanishi R, Yoshimura M, Suno M, Yamamoto K, Ito H, Uchimine Y, Toriumi T, Kurosawa A, Sugawara A, Kunisawa T. Detection of dexmedetomidine in human breast milk using liquid chromatography-tandem mass spectrometry: Application to a study of drug safety in breastfeeding after Cesarean section. J Chromatogr B Analyt Technol Biomed Life Sci. 2017 Jan 1;1040:208-213. doi: 10.1016/j.jchromb.2016.11.015. Epub 2016 Nov 10.

Reference Type RESULT
PMID: 27856195 (View on PubMed)

Yoshimura M, Kunisawa T, Suno M, Sugawara A, Kurosawa A, Nakanishi R, Aoki K, Toriumi T. Intravenous dexmedetomidine for cesarean delivery and its concentration in colostrum. Int J Obstet Anesth. 2017 Nov;32:28-32. doi: 10.1016/j.ijoa.2017.05.002. Epub 2017 May 10.

Reference Type RESULT
PMID: 28687146 (View on PubMed)

Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions. Anesth Analg. 2000 Mar;90(3):699-705. doi: 10.1097/00000539-200003000-00035.

Reference Type RESULT
PMID: 10702460 (View on PubMed)

Wang C, Liu S, Han C, Yu M, Hu Y, Liu C. Effect and placental transfer of dexmedetomidine during caesarean section under epidural anaesthesia. J Int Med Res. 2017 Jun;45(3):964-972. doi: 10.1177/0300060517698330. Epub 2017 Apr 28.

Reference Type RESULT
PMID: 28449631 (View on PubMed)

Jiang W, Wang Q, Xu M, Li Y, Yang R, Song X, Duan H, Zhang P. Assessment of different loading doses of dexmedetomidine hydrochloride in preventing adverse reaction after combined spinal-epidural anesthesia. Exp Ther Med. 2017 Jun;13(6):2946-2950. doi: 10.3892/etm.2017.4335. Epub 2017 Apr 13.

Reference Type RESULT
PMID: 28587365 (View on PubMed)

Chen Z, Tang R, Zhang R, Jiang Y, Liu Y. Effects of dexmedetomidine administered for postoperative analgesia on sleep quality in patients undergoing abdominal hysterectomy. J Clin Anesth. 2017 Feb;36:118-122. doi: 10.1016/j.jclinane.2016.10.022. Epub 2016 Dec 1.

Reference Type RESULT
PMID: 28183547 (View on PubMed)

Deussen AR, Ashwood P, Martis R. Analgesia for relief of pain due to uterine cramping/involution after birth. Cochrane Database Syst Rev. 2011 May 11;(5):CD004908. doi: 10.1002/14651858.CD004908.pub2.

Reference Type RESULT
PMID: 21563142 (View on PubMed)

Kelly LE, Chaudhry SA, Rieder MJ, 't Jong G, Moretti ME, Lausman A, Ross C, Berger H, Carleton B, Hayden MR, Madadi P, Koren G. A clinical tool for reducing central nervous system depression among neonates exposed to codeine through breast milk. PLoS One. 2013 Jul 29;8(7):e70073. doi: 10.1371/journal.pone.0070073. Print 2013.

Reference Type RESULT
PMID: 23922910 (View on PubMed)

Chow CK, Koren G. Sedating drugs and breastfeeding. Can Fam Physician. 2015 Mar;61(3):241-3.

Reference Type RESULT
PMID: 25927109 (View on PubMed)

Newton ER, Hale TW. Drugs in Breast Milk. Clin Obstet Gynecol. 2015 Dec;58(4):868-84. doi: 10.1097/GRF.0000000000000142.

Reference Type RESULT
PMID: 26457856 (View on PubMed)

Anttila M, Penttila J, Helminen A, Vuorilehto L, Scheinin H. Bioavailability of dexmedetomidine after extravascular doses in healthy subjects. Br J Clin Pharmacol. 2003 Dec;56(6):691-3. doi: 10.1046/j.1365-2125.2003.01944.x.

Reference Type RESULT
PMID: 14616431 (View on PubMed)

Lind JN, Perrine CG, Li R. Relationship between use of labor pain medications and delayed onset of lactation. J Hum Lact. 2014 May;30(2):167-73. doi: 10.1177/0890334413520189. Epub 2014 Jan 22.

Reference Type RESULT
PMID: 24451212 (View on PubMed)

Sia AT, Kwek K, Yeo GS. The in vitro effects of clonidine and dexmedetomidine on human myometrium. Int J Obstet Anesth. 2005 Apr;14(2):104-7. doi: 10.1016/j.ijoa.2004.11.004.

Reference Type RESULT
PMID: 15795144 (View on PubMed)

Yu M, Han C, Jiang X, Wu X, Yu L, Ding Z. Effect and Placental Transfer of Dexmedetomidine During Caesarean Section Under General Anaesthesia. Basic Clin Pharmacol Toxicol. 2015 Sep;117(3):204-8. doi: 10.1111/bcpt.12389. Epub 2015 Mar 4.

Reference Type RESULT
PMID: 25652672 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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2015-SR-203

Identifier Type: -

Identifier Source: org_study_id

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