A PROSPECTIVE, RANDOMIZED CONTROLLED STUDY OF INTRAVENOUS DEXMEDETOMIDINE ON 0.5% HYPERBARIC BUPIVACAINE USED IN SPINAL ANAESTHESIA
Background and aims: Local anesthetics along with adjuvants like epinephrine, phenylephrine, adenosine, magnesium sulfate, sodium bicarbonate, neostigmine and alpha-2 agonists like clonidine, dexmedetomidine have been used intrathecally to prolong the duration of spinal anesthesia. Clonidine and dexmedetomidine, used intravenously are also known to prolong the duration of the spinal anesthesia.We proposed this study to evaluate the effect of intravenous dexmedetomidine on 0.5% bupivacaine spinal anesthesia.
Methods: In this prospective, double-blind, randomized controlled clinical trial, 60 patients aged 18 to 60 years, ASA grade 1 or 2 posted for planned elective surgery for more than two hours duration under spinal anesthesia.
study design: The patients were randomly allocated into 2 groups, after giving spinal anesthesia with 0.5% bupivacaine. Group D received a loading dose of 1 ug/kg Dexmedetomidine and Group C received an equivalent quantity of normal saline. The duration of sensory and motor blockade, hemodynamic parameters, postoperative analgesia, time of rescue analgesia, sedation scores and side effects were studied.
Results: The duration of sensory and motor block was significantly prolonged in dexmedetomidine group as compared to control group (p<0.001) Haemodynamic parameters like pulse rate, blood pressure was significantly lower in dexmedetomidine group. Mean time for first request of rescue analgesic in postoperative period was significantly longer in D group (5.43 hrs) as compared to C group (2.43 hrs) (p <0.001) Sedation scores were significantly higher in dexmedetomidine group [4.3+0.47] as compared to control group [2+0.0] (p<0.001) Side effects like shivering, nausea, and vomiting were less in D group
Conclusion: Intravenous dexmedetomidine significantly prolongs the duration of sensory and motor block of bupivacaine spinal anaesthesia, provides excellent sedation and good postoperative analgesia
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