Efficacy of low dose (3µg) dexmedetomidine as adjuvant to 0.5% isobaric ropivacaine in SAB for lower limb surgeries
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 8, Issue 2
Abstract
Background: Dexmedetomidine, a selective α2 adrenergic agonist has found a wide range of applications including intrathecal administration as an adjuvant for local anaesthetics for sub arachnoid block (SAB).Aim: To assess the efficacy of low dose 3 µg dexmedetomidine as an adjuvant in SAB with 0.5% isobaric ropivacaine in lower limb surgeries.Material and methods: This was a randomised controlled study in which 45 ASA I and II patients, of either sex, aged between 18-60 yrs, with lower limb surgeries requiring sub arachnoid block were assignedto three groups of 15 each. Isobaric ropivacaine 0.5 % was used for this study. The Sub arachnoid block in control group (C) wasadministered with isobaric ropivacaine 0.5% 3ml and 0.5ml of normal saline, in second group (H) with isobaric ropivacaine 0.5% 3ml and 5 µg dexmedetomidine diluted with 0.5ml normal saline and in third group (L) with isobaric ropivacaine 0.5% 3ml and 3 µg dexmedetomidine diluted with 0.5ml normal saline. The mean times for 2 segment regression, sensory regression to S2 level and rescue analgesia (in mts) in the 3 groups were assessed and compared. Incidence of intraoperative events such as pain, hypotension and sedation amongst the 3 groups was also noted. ANOVA and Fisher’s tests were used as appropriate and a p<0.05 was considered significant.Results: There was a dose dependent significant increase in Mean time for 2 segment regression (61.4±8.30 vs 80.93±12.7 vs 122.93±15.6), regression to S2 (152.93±15.47 vs 239.46±48.38 vs 330.73±34.31) and rescue analgesia (121.13±28.37 vs 179.6±43.03 vs 226.53±35.56) between the plain ropivacaine, 3 µg and 5 µg groups. Incidence of pain was low while that of complications (hypotension and sedation) was significant in the 5 µg groupConclusion:Low dose(3 µg) intrathecal dexmeditomidine when used as an adjuvant with plain ropivacaine enhances the duration of postoperative analgesia and provides better quality and duration of sensory block when compared to plain ropivaciane with no additional complications.
Authors and Affiliations
Kiran Kumar Anne, Siva Kumar Reddy Lakkireddygari, Sreekanth Yelliboina, Gopinath Ramachandran
Keywords
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- EP ID EP449650
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