Date of this Version

11-27-2023

Document Type

DNP Project

Abstract

Title: Dexmedetomidine as an Adjuvant for Spinal Anesthesia in Adult Patients Undergoing Cesarean Section: An Evidence-Based Educational Module

Impact statement: In adult parturients undergoing cesarean section, the administration of intrathecal dexmedetomidine has proven effective in providing an intraoperative sensory and motor block, in addition to prolonged postoperative analgesia.

Background: Cesarean section performed under spinal anesthesia requires adequate analgesia to block visceral pain. Local anesthetic is usually combined with an adjuvant analgesic drug to relieve perioperative pain. Dexmedetomidine, a potent alpha-2 agonist, has emerged as a popular alternative to opioids, and its use in obstetrics has grown.

Objective: This capstone project aimed to explore the impact of intrathecal dexmedetomidine as an adjunct for spinal anesthesia in adult parturients undergoing cesarean section.

Methodology: A literature review was performed to identify primary research studies and systemic reviews about parturients undergoing cesarean delivery using intrathecal dexmedetomidine. Chosen studies were limited to those published beyond 2015. Databases used for source material included PubMed, EMBASE, and CINAHL. The project was conducted in a local community hospital. An online educational module was created to present to anesthesia providers, in addition to pre- and post-surveys to assess the degree of acquired knowledge. Survey answers were anonymous, and data was collected via an online platform.

Results: Dexmedetomidine is an effective non-opioid adjunct for spinal anesthesia for cesarean section as measured by patients’ nominal perception of pain; it is also associated with fewer side effects than opioids and has been shown to be safe in both the parturient and fetus.

Discussion: Emerging evidence indicates that dexmedetomidine may be used intrathecally for cesarean section. Current data reveals that intrathecal dexmedetomidine provides similar analgesia to opioids with a more desirable side effect profile. Thus, the use of intrathecal dexmedetomidine for obstetrics presents a suitable option for analgesia during cesarean section. The evidence presented in this capstone project elucidates the use of intrathecal dexmedetomidine and establishes that dexmedetomidine is effective, safe, and lacks the negative side effects of opioids. Of note, the most significant limitations of this study were the small sample size and limited timeframe.

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