Dexmedetomine as Adjuvant for Spinal Anesthesia in Elective Cesarian Sections : a Pilot Study

52 patients will be recruted for this study, and will be randomized in two equal groups.

All the interventions carried out will be standardized. Medical care for patients will be the same as usual care, except for administration of dexmedetomidine or intrathecal narcotics.

In the test group, bupivacaine (12 mg, 1.6 ml) will be injected with 3 mcg of dexemedetomidine.

In the second group, bupivacaine (12 mg, 1.6 ml) will be injected with 100 mcg of morphine and 15 mcg of fentanyl with 0.25 ml of normal saline, which corresponds to the standard treatment.

The patients will receive standard analgesia, described in the protocol, post-operatively and will also have access to anti-nausea and anti-pruritics.

The patient will then be seen the day after surgery to collect her validated self-assessment scales for pain, nausea and vomiting, pruritus, chills and complete her QoR15 questionnaire.

This will be collected to establish preliminary data for a second study of non-inferiority for analgesia and gradation of side effects.

Inclusion criteria

• Patient will receive an elective c-section under spinal anesthesia
• Gestational age > 37 weeks

Exclusion criteria

• ASA score ≥ 3
• Allergy or contraindication to receiving opioids (morphine or fentanyl)
• Allergy or contraindication to receiving anti-inflammatory drugs (ketorolac, Naprosyn)
• Allergy or contraindication to receiving acetaminophen
• Height <152 cm or> 183 cm
• Weight <50 or> 110 kg
• Contraindication to spinal anesthesia
• Conversion to general anesthesia
• Combined spinal-epidural anesthesia
• Inability to give informed consent, either secondary to a mental or physical disability or a significant language barrier (Inability to understand English or French)
• Need for transfusion or other major complication