13: Effects of buprenorphine and dexmedetomidine as adjuvants to low dose 0.5% heavy bupivacaine in spinal anaesthesia in patients undergoing transurethral resection of prostate – A comparative study.

Abstract

<bold>Background and Aim:</bold>Benign prostatic hypertrophy is common in elderly men. Spinal anaesthesia is preferred in transurethral resection of prostate (TURP). This study compares sensory, motor effects and haemodynamics of buprenorphine and dexmedetomidine as adjuvants to low dose 0.5% heavy bupivacine in spinal anaesthesia .Methods:fter Institutional Ethics Committee approval, a comparative study was conducted which included 30 elderly male patients in the age group 55-75 years belonging to American Society of Anesthesiologists (ASA) grades I and II physical status scheduled for TURP. Patients were randomised into two groups using computer generated random numbers. Group B (n-15) received 2ml 0.5% heavy bupivacine with 45µg buprenorphine and Group D(n-15) received 2ml 0.5% heavy bupivacine with 5µg dexmedetomidine intrathecally.Intra-operatively,following parameters were recorded: Time of onset of T10 , Highest level of motor block sensory analgesia , Time to regression of motor block to Bromage 0 , Duration of analgesia and haemodynamics .Results:A total of 30 patients were included in the study. The demographic data was comparable between the groups .The duration of analgesia in Group-B was 297±43.3 min and in Group-D 412±74.7 min with P value 0.002). There was low incidence of any perioperative complication such as hypotension, bradycardia,nausea and vomiting.Conclusion:Addition of buprenorphine 45µg or dexmedetomidine 5µg to 0.5% heavy bupivacaine intrathecally in TURP resulted in prolonged duration of analgesia with haemodynamic stability. Dexmedetomidine has prolonged duration of analgesia with significant p value (0.002).Variables (min)Group B (mean±SD)Group D (mean±SD)Onset of T10 block6±2.325.7±3.19Highest sensory levelT6T8Regression of motor blockade to Bromage 0223±25.5333±83.99Duration of Analgesia297±43.3412±74.7