Background: Dexmedetomidine is a sedative agent with high α2-adrenoreceptor selectivity. We investigated intravenous Dexmedetomidine administration during scheduled cesarean delivery under neuraxial anesthesia; and concentration in the colostrum. Methods: Twenty-seven participants having elective cesarean delivery under combined spinal-epidural anesthesia were enrolled. After delivery and cord clamping, 6. μg/kg/h of intravenous dexmedetomidine was administered for 10. minutes, followed by a dose of 0.7. μg/kg/h until peritoneal closure. Sedation, vital signs and side effects were recorded. Blood and colostrum samples were collected from each participant at 6, 12, and 24. h after dexmedetomidine administration. Samples were analysed using liquid chromatography tandem-mass spectroscopy. Results: Colostrum samples were collected from 10 patients. The median [95% CI] plasma dexmedetomidine concentration was 333 [303-534] pg/ml at 0. h and 19.7 [13.5-25.8] pg/ml at 6. h. The colostrum concentration was 12.3 [8.1-20.1] pg/ml at 6. h. The dexmedetomidine completely disappeared from both within 24. h. The calculated milk-to-plasma ratio at 6. h was 0.76 [0.57-0.86]. The relative infant dose was 0.034% [0.020-0.062%]. At dexmedetomidine discontinuation, the Richmond Agitation-Sedation Scale score was -2 (range,-4 to -1). During surgery, no patients complained of nausea, peritoneal irritation or afterbirth pain. Conclusions: The dexmedetomidine milk-to-plasma ratio did not exceed 1 in any participant, and the relative infant dose was very low. Maternal sedation using dexmedetomidine is unlikely to be harmful for the infant.
- Milk-to-plasma ratio
- Relative infant dose
ASJC Scopus subject areas
- Obstetrics and Gynaecology
- Anesthesiology and Pain Medicine