Clinical Evaluation of Adding Fentanyl versus Dexmedetomidine to Intrathecal Isobaric Levobupivacaine on Spinal Block Characteristics in Patients Scheduled for Lower Abdominal Surgeries
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 9
Abstract
Background: Fentanyl, an opioid and dexmedetomidine, an alpha 2 agonist added to local anaesthetics in spinal anaesthesia potentiates local anaesthetics action, have analgesic properties and reduces the requirement of local anaesthetics. Aim: To evaluate the effect of adding fentanyl and dexmedetomidine to intrathecal isobaric levobupivacaine. Materials and Methods: 60 patients scheduled for lower abdominal surgeries at our institute belonging to ASAgrade I-II satisfying inclusion criteria were recruited for the study and randomised to receive levobupivacaine 15mg with dexmedetomidine 5µg in group LD or levobupivacaine 15mg with fentanyl 25 µg in group LF. Sensory and motor block characteristics, haemodynamic changes and side effects were recorded. Results: Onset of sensory block was shorter, time taken to attain maximum sensory block was shorter in group LD as compared to group LF with no stastistical significance. Maximum sensory block achieved was T4 in both the groups. Onset of motor blockade was faster and time taken to attain maximum bromage score 3 was faster in group LD as compared to group LF. Two segment regression duration, duration of analgesia, duration of sensory blockade and motor blockade were stastistically significantly prolonged in group LD as compared to groupLF. Patients maintained haemodynamic stability. Sedation scoring and side effects were insignificant. Data was analysed using Chi-square test and Independent t test. Conclusion: Dexmedetomidine as an adjuvant to isobaric levobupivacaine for spinal anaesthesia fastens sensory, motor onset and enhances the block duration without any significant side effects as compared to fentanyl.
Authors and Affiliations
Threja Chintamani Krishnappa
Dexmedetomidine for Awake Bronchoscopy: Our Experience
Background: Respiratory physicians are showing interest in using Dexmedetomidine for awake sedation, since, it is safe and useful when the patient is having spontaneous breathing and also cost-effective. We evaluated th...
Impact of Education of the Ventilator Associated Pneumonia (VAP) Prevention Bundle on the Incidence of VAP Infections in the Intensive Care Unit (ICU)
Introduction: Ventilator Associated Pneumonia (VAP) is reported to be one of the most common nosocomial infection among patients who are mechanically ventilated in the Intensive Care Unit (ICU). The aim of the present st...
Comparison of Laryngeal Mask Airway Inserted in Prone Position versus Routine Endotracheal Intubation for Prone Surgeries
Background: Providing anaesthesia in prone position is a challenging task for an anaesthesiologist. Although the favourable technique of airway management has been endotracheal tube (ETT), alternative airway management w...
Comparison of Efficacy of Intraperitoneal Instillation of Ropivacaine with Ropivacaine Dexmedetomidine Combination for Post-Operative Analgesia Following Laparoscopic Cholecystectomy
Background and Aims: Intraperitoneal instillation of local anaesthetics is one of the recent techniques to minimize post-operative pain after laparoscopic surgeries. We compared the effects of intraperitoneal instillatio...
A Study to Compare the Effect of Intrathecal Midazolam and Nalbuphine as an Adjuvant to Bupivacaine for Infra-umbilical Surgeries
Context: Since spinal anaesthesia provides analgesia for short time with local anaesthetics, many intrathecal adjuvants to local anaesthetic drugs have been addressed to augment the clinical efficiency and duration of an...