Maternal and preterm fetal sheep responses to dexmedetomidine.

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Uemura, K; Shimazutsu, K; McClaine, RJ; McClaine, DJ; Manson, RJ; White, WD; Benni, PB; Reynolds, JD

Published Date

  • October 2012

Published In

Volume / Issue

  • 21 / 4

Start / End Page

  • 339 - 347

PubMed ID

  • 22938943

Electronic International Standard Serial Number (EISSN)

  • 1532-3374

Digital Object Identifier (DOI)

  • 10.1016/j.ijoa.2012.06.010

Language

  • eng

Conference Location

  • Netherlands