الفهرس 
Chapter 1: Pre-eclampsiaOnly 14 pages are availabe for public view
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Abstract
Pre-eclampsia has an immense adverse impact on maternal and
perinatal health. During general anesthesia, ETI in the women with PE
usually results in stimulation of sympathetic nervous system and
catecholamine release and therefore, increase in blood pressure, HR and
heart load, which may adversely affect the maternal and neonatal wellbeing.
Dexmedetomidine is a highly selective α2 adrenergic receptor
agonist with several diverse actions like sedation, anxiolysis,
sympatholysis, analgesia, decreased intraoperative anesthetic
requirements, cardiovascular stability, and smooth recovery when used as
an adjunct to general anesthesia.
In this study, we aimed to assess the effects of dexmedetomidine as
a part of general anesthesia in patients with PE undergoing cesarean
delivery, including intubation-related stress response, intraoperative
hemodynamics, fetal outcome, and postoperative analgesia. In addition,
the correlation between the maternal and the fetal plasma level of
dexmedetomidine were determined.
This randomized controlled double blind trial was conducted on
(60) patients with mild PE undergoing cesarean section. Patients were
recruited from the obstetrics and gynecology department, Menoufia
university hospitalafter they signed an informed written consent.
Patients were randomly classified into 3 groups, (20) patients each:
Dex 0.4 group, Dex 0.6 group and control group.
Our results revealed that:
1. The MAP and HR of the dexmedetomidine groups were lower than
those of the control group.
2. The serum glucose and cortisol levels were significantly higher in
the control than both Dex 0.4 and Dex 0.6 groups after induction.
3. The VAS was significantly lower in Dex 0.4 and Dex 0.6 groups
than the control group.
4. Thefirst time to require analgesia after cesarean section was
significantly longer in Dex 0.6 and Dex 0.4 groups than the control
group.
5. The total morphine consumption was significantly higher in the
control group than in Dex 0.6 and Dex0.4 groups.
6. Dex 0.6 group patients were significantly more sedated on arrival
to recovery room followed by Dex 0.4 patients as compared to the
control group patients. While after 45 minutes RSS was
comparable in the 3 groups.
7. The 1 and 5 minutes Apgar score was comparable among the
studied groups.
8. There was no significant correlation between the infant
dexmedetomidine level and the 1 and 5 min Apgar score.
9. The rate of utroplacental transfer was comparable in both groups.
10. There was significant positive correlation between mother and
infant dexmedetomidine level.
The results in the present study showed that administration of
dexmedetomidine in doses 0.4–0.6 μg/kg/h in patients with mild preeclampsia
undergoing cesarean delivery was associated with significant
intraoperative hemodynamic and hormonal stability without adverse.