Acomparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to bupivacaine to provide prolonged postoperative analgesia
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 8, Issue 3
Abstract
Background and Objectives: Mixing adjuvants with hyperbaric bupivacaine for intrathecal injection is an practice since long time for reducing dose requirement of bupivacaine and prolongation of duration of action. Short acting liophilic opioid fentanyl and selective apha2 agonist dexmedetomidine is used to reduce dose requirement of bupivacaine and its adverse effects and also to prolong postoperative analgesia. The main objective of the study is to compare efficacy of intrathecal adjuvants i.e., dexmedetomidine and fentanyl with hyperbaric bupivacaine to assess postoperative analgesia and side effectsMaterials and Methods:This prospective, randomized, double blinded and placebo control study was carried out in a tertiary health care centre on 105 patients by randomly allocated into 3 groups and were assigned to receive one of the three intrathecal drugs i.e.,Group D (n=35) received mixture of 0.5% hyperbaric bupivacaine (2.5ml) with Dexmedetomidine (5mcg) intrathecally, Group F(n=35) received mixture of 0.5% hyperbaric bupivacaine (2.5ml) with (25mcg) of fentanyl intrathecally and Group B received 0.5% hyperbaric bupivacaine (2.5ml) and 0.5ml normal saline intrathecally.All the solutions were made up to volume of 3ml in a 5ml syringe.Results: The duration of analgesia was significantly longer in Group D (545±61.94) compare to Group F (437.94±43.32) and Group B (263.97±22.88). Conclusion: Dexmedetomidine an adjuvant to bupivacaine (H) found to be very attractive alternative to fentanyl as it provides excellent postoperative analgesia.
Authors and Affiliations
V Mashalkar Subhash, B Ramadas, Ravi Kumar, Mohammad ShakeebYusufi Attar
Efficacy and safety of bupivacaine instillation through surgical drain in modified radical mastectomy
Background and Aims: modified radical mastectomy (MRM) is the commonly used surgical procedure for operable breast cancer.it involve extensive tissue dissection and infiltration may not have adequate post-operative analg...
Anaesthetic management of a patient with sick sinus syndrome for vaginal hysterectomy
Background: Sick sinus syndrome is a generalised abnormality of cardiac impulse formation that may be caused either by an intrinsic disease of the sinus node, which makes it unable to perform its pacemaking function, or...
Dexmedetomidine versus propofol for attenuation of hemodynamic response to creation of pneumoperitoneum in laparoscopic cholecystectomies: A randomised prospective study
Background: Creation of pneumoperitoneum has been found to be associated with hemodynamic changes and hence various drugs have been studied to attenuate such response. Aims: To compare the effectiveness of dexmedetomidin...
Comparison of I-gel versus proseal laryngeal mask airway (PLMA) for elective surgical elective surgical procedures
Background:Securing airway of patient during surgery is one of the most important responsibility of anesthesiologist.Though Endotracheal Tube is gold standard for securing airway during general anesthesia, various suprag...
Comparison of intracuff dexamethasone, lignocaine and normal saline on post extubation response - A prospective study
Background: Endotracheal intubation, being a definitive method has been known to cause post-intubation airway related adverse effects, including postoperative cough, restlessness, hoarseness, sore throat, bronchospasm, a...