Document Detail


Maternal and preterm fetal sheep responses to dexmedetomidine.
MedLine Citation:
PMID:  22938943     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The α(2) adrenergic receptor agonist dexmedetomidine has some unique pharmacologic properties that could benefit pregnant patients (and their fetuses) when they require sedation, analgesia, and/or anesthesia during pregnancy. The purpose of the present study was to delineate maternal and fetal responses to an intravenous infusion of dexmedetomidine.
METHODS: This study was conducted on surgically-recovered preterm sheep instrumented for physiologic recording and blood sampling. Maternal and fetal cardiovascular and blood gas parameters and fetal cerebral oxygenation levels were recorded before, during, and after 3h of dexmedetomidine infusion to the ewe at a rate of 1 μg/kg/h.
RESULTS: Drug infusion produced overt sedation but no apparent respiratory depression as evidenced by stable maternal arterial blood gases; fetal blood gases were also stable. The one blood parameter to change was serum glucose, By the end of the 3-h infusion, glucose increased from 49±10 to 104±33mg/dL in the ewe and from 22±3 to 48±16mg/dL in the fetus; it declined post-drug exposure but remained elevated compared to the starting levels (maternal, 63±12mg/dL, P=0.0497; and fetal, 24±4mg/dL, P=0.012). With respect to cardiovascular status, dexmedetomidine produced a decrease in maternal blood pressure and heart rate with fluctuations in uterine blood flow but had no discernable effect on fetal heart rate or mean arterial pressure. Likewise, maternal drug infusion had no effect on fetal cerebral oxygenation, as measured by in utero near-infrared spectroscopy.
CONCLUSIONS: Using a clinically-relevant dosing regimen, intravenous infusion of dexmedetomidine produced significant maternal sedation without altering fetal physiologic status. Results from this initial acute assessment support the conduct of further studies to determine if dexmedetomidine has clinical utility for sedation and pain control during pregnancy.
Authors:
K Uemura; K Shimazutsu; R J McClaine; D J McClaine; R J Manson; W D White; P B Benni; J D Reynolds
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-08-28
Journal Detail:
Title:  International journal of obstetric anesthesia     Volume:  21     ISSN:  1532-3374     ISO Abbreviation:  Int J Obstet Anesth     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-01     Completed Date:  2013-03-19     Revised Date:  2013-10-17    
Medline Journal Info:
Nlm Unique ID:  9200430     Medline TA:  Int J Obstet Anesth     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  339-47     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Anesthesiology, Duke University Medical Centre, Durham, NC, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic alpha-2 Receptor Agonists / pharmacology*
Anesthesia / methods
Animals
Blood Gas Analysis / methods
Blood Pressure / drug effects
Brain / drug effects
Dexmedetomidine / pharmacology*
Female
Fetal Blood / drug effects*
Fetal Heart / drug effects*
Fetus / drug effects
Heart Rate / drug effects
Heart Rate, Fetal / drug effects
Hemodynamics / drug effects
Oxygen
Pregnancy
Pregnancy, Animal / drug effects*
Regional Blood Flow / drug effects
Sheep*
Spectroscopy, Near-Infrared / methods
Grant Support
ID/Acronym/Agency:
HD 042471/HD/NICHD NIH HHS; NS 042664/NS/NINDS NIH HHS; R01 HD042471/HD/NICHD NIH HHS; R21 NS042664/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Adrenergic alpha-2 Receptor Agonists; 113775-47-6/Dexmedetomidine; 7782-44-7/Oxygen
Comments/Corrections

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