Intravenous dexmedetomidine as an adjuvant in anesthetic management of a paturient for cesarean section with uncontrolled hyperthyroidism

Parturients with uncontrolled hyperthyroidism presenting as urgent cesarean section are at high-risk. A 34-year-old, G4P3 parturient, at 34+5 weeks of gestation, with uncontrolled hyperthyroidism presented for urgent cesarean section. A combined spinal-epidural anesthesia was performed. Intravenous dexmedetomidine, as an adjuvant, was specifically administered during and after the surgery. Approximately 30 min after administrating of dexmedetomidine, materal heart rate and blood pressure gradually remained stable. The baby was delivered 36 min after infusion of the dexmedetomidine with a total use of 83 μg. The Apgar score was 7 at 1 min and 10 at 5 min, respectively. The fetal concentration of dexmedetomidine (608 pg/mL) indicates significant placental transfer, but significant adverse neonatal effects were not observed. Dexmedetomidine was very effective in the control of the sympathetic hyperactivity with no adverse effects on both mother and neonate in this case.