Clin Drug Investig. 2026 Mar 30. doi: 10.1007/s40261-026-01547-x. Online ahead of print.
ABSTRACT
BACKGROUND AND OBJECTIVE: Carboprost tromethamine is commonly used to prevent or treat postpartum hemorrhage during cesarean section but causes frequent side effects. This study aimed to compare dexmedetomidine and sufentanil for preventing these side effects and assess hemodynamic stability.
METHODS: This is a single-center randomized controlled trial. Parturients undergoing elective cesarean section were randomized to Group D (dexmedetomidine intravenously), Group S (sufentanil intravenously), and Group C (saline intravenously). Carboprost tromethamine 250 µg was intrauterine injected after delivery. The incidence of complications, Ramsay sedation scores, and noninvasive cardiac system-derived hemodynamic parameters were analyzed. The primary endpoint is dexmedetomidine or sufentanil could relieve the nausea and vomiting caused by carboprost tromethamine.
RESULTS: A total of 152 subjects were included in the analysis. Both Groups D and S had significantly fewer intraoperative nausea and vomiting episodes (Group D 16% vs Group S 19.2% vs Group C 76%, P < 0.001) and higher Ramsay scores (P < 0.001) compared with Group C. Group C showed significant increases in mean arterial pressure and respiratory rate (P < 0.05). Heart rate in Group D was significantly lower than in Group C (P < 0.05). The total peripheral resistance was significantly lower in Group S at T2-T5 (from 2 minutes post-carboprost tromethamine until the end of surgery) and in Group D at T2-T4 (2, 5, and 10 minutes post-carboprost tromethamine) compared with Group C (P < 0.05). Cardiac output in Group S was higher at T2-T4 (2, 5, and 10 minutes post-carboprost tromethamine) than in Group C, and at T2-T3 (2 and 5 minutes post-carboprost tromethamine), it was even higher than in Group D (P < 0.05).
CONCLUSIONS: Both dexmedetomidine and sufentanil alleviated carboprost tromethamine-induced side effects while maintaining stable hemodynamics. Sufentanil showed greater efficacy in reducing peripheral vascular resistance.
CLINICAL TRIAL REGISTRATION: ChiCTR2000038350.
PMID:41910933 | DOI:10.1007/s40261-026-01547-x
