A Comparative Study between Dexmedetomidine, Labetalol and Hydralazine for Preeclampsia Patient Undergoing Cesarean Section Under General Anesthesia

Abstract

P reeclampsia is a pregnancy-specific, multisystem disorder occurring after 20 weeks of gestation. Recent findings show that Preeclampsia is a major cause of maternal morbidity and mortality especially due to the high risk of occurrence of cerebral hemorrhage which occur due to hypertension, which may be a great challenge for many anesthetists because of hypertension as during general anesthesia blood pressure increases due to stress response associated with laryngoscopy and intubation. Many drugs are being used for control blood pressure like hydralazine, labetalol, Na nitroprusside and nitroglycerin. Na nitroprusside and nitroglycerin have been shown to cause tachycardia and significantly affect placental blood flow. Hydralazine has a disadvantage of having longer duration of action, maternal tachycardia and fetal distress and there are reported cases of persistent hypertension on using labetalol. Dexmedetomidine is a centrally acting Alpha (α)-2-Adrenergic receptor agonists, which has been the focus of interest for its sedative, analgesic, perioperative sympatholytic properties as it helps in attenuating the stress responses to tracheal intubation, extubation and emergence from anesthesia. It had been used as a sedative-analgesic and/or total anesthetic in adults and pediatric patients undergoing small minimally invasive procedures. This study was done to acessand compare hemodynamic stability between dexmedetomidine, labetalol and hydralazine in preeclampsia patients undergoing caesarian section under general anesthesia .Sixty patients, of ASA III were randomized either to receive hydralazine, labetalol or dexmedetomidine in three groups.