Spinal Anaesthesia for Infra-umbilical Surgeries - A Prospective Randomized Study to evaluate the effectiveness of Dexmedetomidine as an adjuvant to Bupivacaine.

Spinal Anesthesia for infra-umbilical surgeries.

Abstract

Background: Spinal anesthesia is commonly used anesthetic modality worldwide but with the limitation of relatively short duration of action and complain of post-operative pain. However, the addition of adjuvants have intensified and increased the duration of sensory block with concommitent prolongation of the duration of postoperative analgesia.

Study design and settings: This prospective randomized study was conducted in the Department of Anesthesia, Pain and Critical Care at the University Teaching Hospital.

Methods: 60 patients irrespective of their age and gender were randomized equally into two groups, and received 3ml of total drug volume intrathecally (IT) viz 2.5 ml of hyperbaric bupivacaine 0.5% mixed with 0.5 ml of normal saline in Group I and 0.5 ml of 5 mcg of Dexmedetomidine in Group II respectively.

Results: The maximum height of sensory block achieved were dermatomes T 6.5 ± 1.43 in Group I, and T 6.20 ± 1.28 in Group II (P value, 0.794 > 0.05) with time required to reach T10 sensory block level was 6.70 ± 0.98 min. in Group I and 5.50 ± 1.00 min. in Group II (P value, 0.001) The time to reach Bromage scale 3 was   15.70 ± 2.56 min. in Group I and 8.55 ± 1.67min. in Group II (P value, < 0.001) The time of first rescue dose requested by patient was 196.75 ± 15.16 min. in Group I, and 359.50 ± 49.79 min. in Group II (P value,  0.01)                                          

Conclusions: Dexmedetomidine in doses of 5 µg as adjuvants to hyperbaric 0.5% bupivacaine intrathecally produced a significantly quick onset and longer duration of motor and sensory block with benefit prolonged postoperative analgesia. JMS 2018: 21 (2):95-100