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Uemura K, Shimazutsu K, McClaine RJ, et al. Maternal and preterm fetal sheep responses to dexmedetomidine. Int J Obstet Anesth. 2012;21(4):339-47doi: 10.1016/j.ijoa.2012.06.010.
Uemura, K., Shimazutsu, K., McClaine, R. J., McClaine, D. J., Manson, R. J., White, W. D., Benni, P. B., & Reynolds, J. D. (2012). Maternal and preterm fetal sheep responses to dexmedetomidine. International journal of obstetric anesthesia, 21(4), 339-47. https://doi.org/10.1016/j.ijoa.2012.06.010
Uemura, K, et al. "Maternal and preterm fetal sheep responses to dexmedetomidine." International journal of obstetric anesthesia vol. 21,4 (2012): 339-47. doi: https://doi.org/10.1016/j.ijoa.2012.06.010
Uemura K, Shimazutsu K, McClaine RJ, McClaine DJ, Manson RJ, White WD, Benni PB, Reynolds JD. Maternal and preterm fetal sheep responses to dexmedetomidine. Int J Obstet Anesth. 2012 Oct;21(4):339-47. doi: 10.1016/j.ijoa.2012.06.010. Epub 2012 Aug 28. PMID: 22938943; PMCID: PMC3462238.
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Int J Obstet Anesth. 2012 Oct;21(4):339-47. doi: 10.1016/j.ijoa.2012.06.010. Epub 2012 Aug 28.

Maternal and preterm fetal sheep responses to dexmedetomidine.

International journal of obstetric anesthesia

K Uemura, K Shimazutsu, R J McClaine, D J McClaine, R J Manson, W D White, P B Benni, J D Reynolds

Affiliations

  1. Department of Anesthesiology, Duke University Medical Centre, Durham, NC, USA.

PMID: 22938943 PMCID: PMC3462238 DOI: 10.1016/j.ijoa.2012.06.010

Abstract

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.

Copyright © 2012 Elsevier Ltd. All rights reserved.

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