Comparison of intrathecal dexmedetomidine - 0.5% heavy bupivacaine combination with intrathecal 0.5% heavy bupivacaine alone for lower limb and lower abdominal surgeries
Journal Title: Medpulse International Journal of Anesthesiology - Year 2017, Vol 4, Issue 2
Abstract
Aims: To assess the effects of intrathecal dexmedetomidine on the onset and duration of action of sensory and motor block, haemodynamic alteration, associated complications, level of sedation and intraoperative analgesia. Methods: The study consists of 100 patients scheduled for lower abdominal and lower limb surgeries. Patients were randomly allocated in 2 groups. Group -1 received 0.5% Hyperbaric bupivacaine 3cc (15 mg) and Group-2: received 0.5% hyperbaric bupivacaine (15mg) + 5ug Dexmedetomidine. Time of onset of sensory blockade, maximum level of sensory blockade, time to achieve maximum level of sensory blockade, and maximum level of motor blockade, duration of maximum motor blockade, time for segment regression of Sensory blockade, total duration of analgesia and sedation, and incidence of side effects were recorded. Result: Mean duration of onset of sensory blockade to level T10 with Group 1 was 9.70±1.23minute while it was 6.84±0.93 minutes with Group 2. Mean duration of onset of maximum sensory blockade to level T6 in Group was 18.86 ± 1.77 minute while it was 17.30 ± 1.88 minute with Group 2. Mean duration of onset of maximum motor blockade to bromage 3 with Group 1 was 21.86 ± 1.68 minute while it was 13.12 ± 1.00 minute with Group 2. Mean duration of segment regression of sensory blockade to level S1 segment prolonged in Group 2. (Group 1-170.24 ± 10.53 minute while it was 296.90 ± 22.24minute with Group 2) (p-value<0.001). Mean duration of regression of motor blockade to bromage 0 with group 1 was 147.02 ± 9.58minute while it was 254.60 ± 13.99 minute with group 2. Duration of analgesia was measured as time interval between intrathecal injection to patients 1st request of analgesic. It was prolonged in group 2. (Group 1 -184.52 ± 13.83 minute, Group 2 -344.60 ± 31.51minute). There is no significant difference between mean heart rate and MAP in group 1 and group 2. Sedation was assessed by Ramsays sedation score graded from 1 to 6 depending upon whether patient is awake or in deep sleep. Sedition in patients in whom dexmedetomidine was used was comparatively more than with bupivacaine alone. There no significant difference of side effects in group 1 and group 2. Conclusion: Addition of dexmedetomidine to intrathecal bupivacaine produced significantly fast onset of sensory and motor block as well as significantly longer duration of sensory and motor block than bupivacaine alone without serious side effects
Authors and Affiliations
Deoshri Bal Ramteke, Surekha Shinde
Keywords
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