Adding Dexmedetomidine or Clonidine to Spinal Anesthesia for Cesarean Delivery
Columbia University
Summary
This study will examine whether addition of dexmedetomidine or clonidine (two alpha-2 adrenergic agonists) will improve the comfort of patients during spinal anesthesia for cesarean delivery. When added to standard spinal anesthesia consisting of bupivacaine (a local anesthetic) and fentanyl and morphine (two opioids), these medications may decrease some of the pulling/tugging/pressure sensations that patients sometimes feel during cesarean delivery, may prolong the anesthetic time, and may decrease postoperative pain.
Description
While spinal anesthesia almost always creates a reasonably comfortable operative/birth experience, a significant proportion of women do experience significance "pressure" or "pulling" and some do have sensations described as painful during the operation. This has received increased interest in both the medical and lay press in recent years. The main medication in a spinal anesthetic is the local anesthetic, usually bupivacaine, but a variety of adjuvants can and are used to improve the analgesia and decrease sensation (or increase the time period of effectiveness) of the anesthetic. Opioids (u…
Eligibility
- Age range
- 18+ years
- Sex
- Female
- Healthy volunteers
- No
Inclusion Criteria: * Pregnant women undergoing cesarean delivery with spinal anesthesia Exclusion Criteria: * Significant cardiovascular, psychiatric or respiratory disease * using opioids or with chronic pain syndrome * Multiple gestation * BMI \>40 kg/m2 * Quaternary or greater cesarean * \< 37 weeks gestation * Non-English or Spanish speaking * planned vertical skin incision * planned vertical (classical) uterine incision * allergy to clonidine, dexmedetomidine or other study drug
Interventions
- DrugClonidine
30 mcg Clonidine will be given by intrathecal administration
- DrugDexmedetomidine
4 mcg Dexmedetomidine will be given by intrathecal administration
Location
- Columbia University Irving Medical Center/NewYork Presbyterian HospitalNew York, New York