Intrathecal dexmedetomedine and magnesium sulphate as an adjuvants to hyperbaric bupivacaine in pregnancy induced hypertensive patients: A clinical comparative study
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 5, Issue 2
Abstract
Background and Aims: Providing a safe anaesthesia and analgesia with a stable hemodynamic and with no neonatal adverse effects to a preeclamptic caesarean patients is a challenging task. Various adjuvants have been tried with intrathecal bupivacaine in the past to achieve this goal. This study was designed to evaluate and compare the analgesic efficacy of dexmedetomedine and magnesium sulphate when used as an adjuvant to intrathecal 0.5% bupivacaine in mild preeclamptic patient posted for caesarean. Methods: Sixty patients of mild preeclampsia posted for caesarean section under spinal anaesthesia were randomly allocated into two groups. Group D received 2ml 0.5% bupivacaine with 10 micro grams of dexmedetomedine and group M received 2ml 0.5% bupivacaine with 50 mg of magnesium sulphate. The primary outcome was duration of postoperative analgesia and secondary outcomes were onset and duration of sensory and motor block, hemodynamic changes, sedation and neonatal APGAR and ABG values. Data were analysed with the Kolmogorov-Smirnov test, independent t-test and chi-square test. Results: The time to reach peak sensory level was shorter in group D (4±0.4 min) than group M (8.0±0.9min) with a p<0.001. In Group D the duration of motor block was longer (200±6.1 min vs 180±8 min) with the early onset of motor block (6.3±0.7 min vs 6.9±0.9) compared with group M. The onset of postoperative pain was significantly earlier in group M (160±27 min vs 243±35 min) with a p value < 0.001 and more patients in group M (26/30 vs 9/30) needed supplementary analgesics than group D. No clinically significant difference was observed in the rate of occurrence of hypotension and bradycardia between the two groups. No significant difference was observed between the two groups regarding the APGAR score and maternal side effects like sedation.
Authors and Affiliations
Santosh Kumar Bennur, Sanjeev G M
Keywords
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