{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T23:08:06Z","timestamp":1793747286507,"version":"4.6.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Prompt diagnosis and treatment of increased intracranial tension (ICT) critically impact outcomes in patients with severe pre-eclampsia. This study aimed to investigate the influence of dexmedetomidine (DEX) infusion on optic nerve sheath diameter (ONSD), utilised as a surrogate marker for ICT assessment, in pre-eclamptic patients presenting with severe features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Fifty parturients with a confirmed diagnosis of severe pre-eclampsia were included in the study cohort. Participants were randomly allocated to receive either a DEX infusion 0.2\u20130.7 \u03bcg\/kg\/h or a matching volume of 0.9% saline as a control, both regimens co-administered with standard magnesium sulphate therapy (4 g loading dose and 1 g\/h maintenance). Infusions were continued until surgical completion. The primary outcome was ONSD measured at baseline and at 6, 12, 24, and 48 h post-infusion. Secondary outcomes included haemodynamic variables, sedation scores, neonatal APGAR scores, incidence of adverse events, and length of hospitalisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Both groups exhibited comparable demographic characteristics. ONSD showed significantly decreased values after DEX infusion compared to baseline (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05) at all time points. Additionally, haemodynamic variables were significantly reduced compared to baseline in both groups. However, no substantial variations were detected between the two groups. APGAR score, sedation score, length of hospitalisation, and side effects showed no remarkable events, with comparable values between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Dexmedetomidine infusion in combination with magnesium sulphate effectively mitigates the elevation of intracranial tension observed in pre-eclamptic patients with severe features without increasing maternal or neonatal adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_19_25","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T10:00:15Z","timestamp":1752141615000},"page":"786-793","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Effect of dexmedetomidine combined with magnesium sulphate on intracranial tension in patients with severe pre-eclampsia using ultrasonographic optic nerve sheath Diameter - A randomised clinical trial"],"prefix":"10.4103","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9631-5768","authenticated-orcid":false,"given":"Enas W.","family":"Mahdy","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Benha Faculty of Medicine, Benha University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4099-3759","authenticated-orcid":false,"given":"Taghreed E.","family":"Sakr","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Benha Faculty of Medicine, Benha University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1122-6692","authenticated-orcid":false,"given":"Samar R.","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Benha Faculty of Medicine, Benha University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7,10]]},"reference":[{"key":"R1-20260421","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1067\/mob.2000.107928","article-title":"Report of the National High Blood Pressure Education Program Working Group on high blood pressure in pregnancy","volume":"183","year":"2000","journal-title":"Am J Obstet Gynecol"},{"key":"R2-20260421","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1067\/S0002-9378(03)00651-3","article-title":"Diffusion imaging may predict reversible brain lesions in eclampsia and severe preeclampsia: Initial experience","volume":"189","author":"Loureiro","year":"2003","journal-title":"Am J Obstet Gynecol"},{"key":"R3-20260421","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.annemergmed.2006.06.040","article-title":"Emergency department sonographic measurement of optic nerve sheath diameter to detect findings of increased intracranial pressure in adult head injury patients","volume":"49","author":"Tayal","year":"2007","journal-title":"Ann Emerg Med"},{"key":"R4-20260421","first-page":"22","article-title":"Optic nerve sheath ultrasound for the bedside diagnosis of intracranial hypertension: Pitfalls and potential","volume":"1","author":"Shevlin","year":"2015","journal-title":"Crit Care Horizons"},{"key":"R5-20260421","doi-asserted-by":"crossref","first-page":"128","DOI":"10.4103\/0259-1162.94750","article-title":"Current role of dexmedetomidine in clinical anaesthesia and intensive care","volume":"5","author":"Kaur","year":"2011","journal-title":"Anesth Essays Res"},{"key":"R6-20260421","doi-asserted-by":"crossref","first-page":"3","DOI":"10.4103\/2249-4472.114253","article-title":"Dexmedetomidine in pregnancy: Review of literature and possible use","volume":"3","author":"Nair","year":"2013","journal-title":"J Obstet Anaesth Crit Care"},{"key":"R7-20260421","first-page":"e1","article-title":"ACOG practice bulletin no. 202: Gestational hypertension and preeclampsia","volume":"133","author":"Espinoza","year":"2019","journal-title":"Obstet Gynecol"},{"key":"R8-20260421","doi-asserted-by":"crossref","first-page":"14","DOI":"10.4103\/sja.SJA_887_20","article-title":"Effect of magnesium sulphate on the intracranial pressure of preeclampsia patients using ultrasound-guided optic nerve sheath diameter: A pilot study","volume":"15","author":"Omran","year":"2021","journal-title":"Saudi J Anaesth"},{"key":"R9-20260421","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.jcrc.2009.02.001","article-title":"Comparison between dexmedetomidine and midazolam for sedation of eclampsia patients in the intensive care unit","volume":"24","author":"Esmaoglu","year":"2009","journal-title":"J Crit Care"},{"key":"R10-20260421","first-page":"2415","article-title":"A study of efficacy of dexmedetomidine and midazolam for sedation of eclamptic patients on mechanical ventilation in ICU","volume":"6","author":"Sharma","year":"2017","journal-title":"J Evol Med Dent Sci JEMDS"},{"key":"R11-20260421","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.egja.2016.08.015","article-title":"Remifentanil vs dexmedetomidine for severely preeclamptic parturients scheduled for cesarean section under general anaesthesia: A randomized controlled trial","volume":"32","author":"Badawy","year":"2016","journal-title":"Egypt J Anaesth"},{"key":"R12-20260421","first-page":"1","article-title":"Evaluation the effects of intravenous vs. spinal dexmedetomidine during anaesthesia for cesarean sections with severe pre-eclampsia","volume":"9","author":"Elgebaly","year":"2018","journal-title":"J Anesth Clin Res"},{"key":"R13-20260421","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.23736\/S0375-9393.18.12312-1","article-title":"Comparison of the effects of low doses of dexmedetomidine and remifentanil on the maternal hemodynamic changes during caesarean delivery in patients with severe preeclampsia: A randomized trial","volume":"84","author":"El-Tahan","year":"2018","journal-title":"Minerva Anestesiol"},{"key":"R14-20260421","doi-asserted-by":"crossref","first-page":"4742350","DOI":"10.1155\/2022\/4742350","article-title":"[Retracted] Effect of dexmedetomidine on cardiac output among parturient with severe preeclampsia after cesarean section","volume":"2022","author":"Lv","year":"2022","journal-title":"Comput Math Methods Med"},{"key":"R15-20260421","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1161\/HYPERTENSIONAHA.122.19408","article-title":"Brain vascular dysfunction in mothers and their children exposed to preeclampsia","volume":"80","author":"Escudero","year":"2023","journal-title":"Hypertension"},{"key":"R16-20260421","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1113\/expphysiol.2007.039966","article-title":"Magnesium sulphate treatment decreases blood\u2013brain barrier permeability during acute hypertension in pregnant rats","volume":"93","author":"Euser","year":"2008","journal-title":"Exp Physiol"},{"key":"R17-20260421","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1007\/s00134-014-3392-7","article-title":"Optic nerve sheath diameter on computed tomography is correlated with simultaneously measured intracranial pressure in patients with severe traumatic brain injury","volume":"40","author":"Sekhon","year":"2014","journal-title":"Intensive Care Med"},{"key":"R18-20260421","first-page":"120","article-title":"Diagnostic evaluation of optic nerve sheath diameter in predicting elevated intracranial pressure among neurocritically ill patients: A prospective observational study","volume":"14","author":"Kasinathan","year":"2024","journal-title":"Int J Crit Illn Inj Sci"},{"key":"R19-20260421","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.ijoa.2018.06.005","article-title":"Ocular ultrasonography for diagnosing increased intracranial pressure in patients with severe preeclampsia","volume":"36","author":"Simenc","year":"2018","journal-title":"Int J Obstet Anesth"},{"key":"R20-20260421","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1038\/s41589-020-0492-2","article-title":"Activation of the \u03b12B adrenoceptor by the sedative sympatholytic dexmedetomidine","volume":"16","author":"Yuan","year":"2020","journal-title":"Nat Chem Biol"},{"key":"R21-20260421","doi-asserted-by":"crossref","first-page":"846","DOI":"10.3390\/brainsci11070846","article-title":"The current role of dexmedetomidine as neuroprotective agent: An updated review","volume":"11","author":"Liaquat","year":"2021","journal-title":"Brain Sci"},{"key":"R22-20260421","doi-asserted-by":"crossref","first-page":"341","DOI":"10.4103\/joacp.JOACP_171_17","article-title":"Effect of dexmedetomidine on intracranial pressures during laparoscopic surgery: A randomized, placebo-controlled trial","volume":"34","author":"Sahay","year":"2018","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"R23-20260421","doi-asserted-by":"crossref","first-page":"e16772","DOI":"10.1097\/MD.0000000000016772","article-title":"Dexmedetomidine attenuates the increase of ultrasonographic optic nerve sheath diameter as a surrogate for intracranial pressure in patients undergoing robot-assisted laparoscopic prostatectomy: A randomized double-blind controlled trial","volume":"98","author":"Yu","year":"2019","journal-title":"Medicine"},{"key":"R24-20260421","first-page":"6349","article-title":"Effect of dexmedetomidine on intracranial pressure in patients undergoing gynecological laparoscopic surgery in Trendelenburg position through ultrasonographic measurement of optic nerve sheath diameter","volume":"14","author":"Zhu","year":"2022","journal-title":"Am J Transl Res"},{"key":"R25-20260421","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1111\/anae.13084","article-title":"Echocardiographic evaluation of the effects of dexmedetomidine on cardiac function during total intravenous anaesthesia","volume":"70","author":"Lee","year":"2015","journal-title":"Anaesthesia"},{"key":"R26-20260421","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1046\/j.1365-2044.1999.01114.x","article-title":"Preliminary UK experience of dexmedetomidine, a novel agent for postoperative sedation in the intensive care unit","volume":"54","author":"Venn","year":"1999","journal-title":"Anaesthesia"},{"key":"R27-20260421","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1097\/00000542-200008000-00016","article-title":"The effects of increasing plasma concentrations of dexmedetomidine in humans","volume":"93","author":"Ebert","year":"2000","journal-title":"Anesthesiology"},{"key":"R28-20260421","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1177\/0300060517708945","article-title":"Intravenous dexmedetomidine during spinal anaesthesia for caesarean section: A meta-analysis of randomized trials","volume":"45","author":"Bao","year":"2017","journal-title":"J Int Med Res"},{"key":"R29-20260421","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1097\/00000542-200302000-00024","article-title":"The alpha2-adrenoceptor agonist dexmedetomidine converges on an endogenous sleep-promoting pathway to exert its sedative effects","volume":"98","author":"Nelson","year":"2003","journal-title":"Anesthesiology"}],"container-title":["Indian Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_19_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:51:36Z","timestamp":1786647096000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_19_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,10]]},"references-count":29,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ija.ija_19_25","relation":{},"ISSN":["0019-5049","0976-2817"],"issn-type":[{"value":"0019-5049","type":"print"},{"value":"0976-2817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,10]]},"assertion":[{"value":"2025-01-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-06","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}