Comparative Study of two Different Doses of Dexmedetomidine with Hyperbaric Bupivacaine in Spinal Anaesthesia in Lower Limb Surgeries
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2016, Vol 4, Issue 3
Abstract
Effective perioperative pain management during lower limb surgeries has been demonstrated to decrease associated morbidity and ameliorate patient’s post operative outcome. Dexmedetomidine which is a selective alpha-2 agonist has recently been reported to be used as adjuvant to prolong spinal anesthesia. The present study was done to evaluate the onset and duration of sensory and motor block, haemodynamic changes as well as post operative analgesia and adverse effects of adding dexmedetomidine to hyperbaric bupivacaine for lower limb surgery in spinal anesthesia. The present study was done at Dept. of Anaesthesiology Gandhi Medical College, Bhopal on 60 patients, who were divided into two groups: Group D5 (received 3 ml hyperbaric 0.5% bupivacaine 15 mg +5 µg dexmedetomidine) and Group D10 (received 3 ml hyperbaric 0.5% bupivacaine 15 mg +10 µg dexmedetomidine). Preloading was done followed by spinal anesthesia at the level of L3-L4 using a 25-gauge Quincke spinal needle. Blood pressure, heart rate and partial pressure of oxygen was monitored before performing the spinal anesthesia, and once in every 5 minutes, then after every 15 minutes in the Post Anesthesia Care Unit (PACU) till the recovery of sensory and motor functions. In the PACU, the sensory level and Bromage scale were recorded every 15 minutes until the patient was discharged from the PACU. The level of sedation was evaluated just before surgery, intra operatively and post-operatively every 15 minutes using the Ramsay sedation scales. The time to reach T10 sensory dermatome in group D5and group D10 was 3.5±0.8 min and 3.1±0.5 min and time to reach Bromage 3 scale was 4.4±1.2 min and 3.9±1.0 min respectively (p>0.05). The regression of the sensory block to S1 dermatome in group D5 and Group D10 was 249.6+26.8 min and 340.2±42.9 min respectively and motor block to Bromage scale 0 was 225.0+23.3 min and 302.1±31.5 min respectively (p<0.001). Keywords: exmedetomidine, perioperative pain, motor block.
Authors and Affiliations
Dr. Hansraj Baghel, Dr. Raju Singh Rathor, Dr. Vikas Gupta
Keywords
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