Cesarean delivery anesthesia with a paravertebral block and intravenous dexmedetomidine

Published:August 02, 2022DOI:
      Cesarean delivery anesthesia is challenging if the parturient is at high risk for general anesthesia and has a contraindication for neuraxial anesthesia. Local anesthesia provides inadequate anesthesia for cesarean delivery, and therefore, may be unethical. Hence, we propose a technique of paravertebral block with intravenous dexmedetomidine for cesarean delivery anesthesia in this special situation.
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      1. Mitchell KD, Smith CT, Mechling C, Wessel CB, Orebaugh S, Lim G. A review of peripheral nerve blocks for cesarean delivery analgesia. Reg Anesth Pain Med 2019; Oct 25:rapm-2019-100752. doi: 10.1136/rapm-2019-100752.

        • Labor S.
        • Maguire S.
        The pain of labour.
        Rev Pain. 2008; 2: 15-19
        • Suelto M.D.
        • Shaw D.B.
        Labor analgesia with paravertebral lumbar sympathetic block.
        Reg Anesth Pain Med. 1999; 24: 179-181
        • Suelto M.D.
        Paravertebral lumbar sympathetic block for labor analgesia.
        Anesthesiology. 2000; 93: 580
        • Zhang Q.
        • Zhen J.
        • Hui Z.
        • et al.
        Effect of dexmedetomidine on oxytocin-induced uterine contraction during optimal caesarean section anaesthesia.
        Basic Clin Pharmacol Toxicol. 2022; 131: 53-59
        • Bi Y.H.
        • Cui X.G.
        • Zhang R.Q.
        • Song C.Y.
        • Zhang Y.Z.
        Low dose of dexmedetomidine as an adjuvant to bupivacaine in cesarean surgery provides better intraoperative somato-visceral sensory block characteristics and postoperative analgesia.
        Oncotarget. 2017; 8: 63587-63595
        • Ao L.
        • Shi J.
        • Bai Y.
        • Zheng Y.
        • Gan J.
        Effectiveness and safety of intravenous application of dexmedetomidine for cesarean section under general anesthesia: a meta-analysis of randomized trials.
        Drug Des Devel Ther. 2019; 13: 965-974
        • Zhang J.
        • Zhou H.
        • Sheng K.
        • Tian T.
        • Wu A.
        Foetal responses to dexmedetomidine in parturients undergoing caesarean section: a systematic review and meta-analysis.
        J Int Med Res. 2017; 45: 1613-1625
        • Gong W.Y.
        • Zhang J.Y.
        • Wang A.Z.
        • Fan K.
        The combination of paravertebral block and cervical vagus nerve block applied alone for anaesthesia of open appendectomy during COVID-19.
        Anaesth Crit Care Pain Med. 2022; 41: 101091