Clinical benefit of dexmedetomidine in combination with dezocine as epidural anesthesia during cesarean delivery for pregnant women with gestational diabetes mellitus

Abstract

Purpose: To investigate the clinical benefit of dexmedetomidine (DEX) when used in combination with dezocine as epidural anesthesia during cesarean delivery for puerperae with gestational diabetes mellitus (GDM).Methods: A total of 120 puerperae with GDM admitted to The Fourth Hospital of Shijiazhuang (Obstetrics and Gynecology Hospital Affiliated to Hebei Medical University, Shijiazhuang City, China) who underwent cesarean delivery from January 2019 to January 2020 were randomly assigned to groups A and B, with 60 patients per group. Epidural anesthesia with dezocine was used on patients in both groups, while DEX was added for patients in group A. Comparison was made between the 2 groups with regard to pregnancy outcomes, pain scores, maternal and infant blood glucose levels, hemodynamic indices, hormonal levels and adverse reaction rates (ARR).Results: Patients in group A had significantly better maternal and infant outcomes (p < 0.05), lower maternal postoperative pain scores (p < 0.05), lower maternal postoperative blood glucose levels (p < 0.001), higher infant postoperative blood glucose levels (p < 0.001). Furthermore, maternal incidence of adverse reactions in group A was lower than in group B (p <0.05). At the time point of 0.5 h after anesthesia and operation, the hemodynamic indices of puerperae in group A were significantly more stable, and levels of estradiol and prolactin were higher, relative to those in group B (p < 0.05). However, group A had a lower chemotaxin levels at immediate postoperative period and 1 day after operation than group B (p < 0.05).Conclusion: The combination of DEX and dezocine for epidural anesthesia stabilizes hemodynamics, improves hormone levels and lowers the incidence of adverse reactions in puerperae with GDM, thereby potentially ensuring better pregnancy outcomes and well-controlled blood glucose levels. Therefore, this strategy for epidural anesthesia has potentials for use in clinical practice.