Comparative Study to Evaluate the Efficacy of Dexmedetomidine and Magnesium Sulfate as Adjuvants to 0.5% of Hyperbaric Bupivacaine in Patient Undergoing Abdominal Hysterectomy by Spinal Anesthesia: A Randomized, Double-blind Study

Abstract

Abstract Objective: Abdominal hysterectomy is a common gynecological procedure. While spinal anesthesia offers pain relief, its short analgesic effect is limiting. In this context, there are not many research that examined magnesium sulfate, dexmedetomidine, and 0.5% hyperbaric bupivacaine. Our research addresses this gap as “Comparing Dexmedetomidine and Magnesium Sulfate as Adjuvants to Hyperbaric Bupivacaine for Abdominal Hysterectomy”. Methods: Ninety patients with the American Society of Anesthesiologists Classification I and II, aged 30–60, planned for abdominal hysterectomy were randomized to either dexmedetomidine or magnesium sulfate or control group as adjuvants to hyperbaric bupivacaine. The primary objective was to find the effectiveness of the anesthesia in terms of both sensory and motor blocks (onset, duration, and severity), with the secondary objective was to find out any other associated complications. Results: In comparison to the magnesium sulfate group, the dexmedetomidine group’s anesthetic effect began significantly more immediately and persisted much longer (P < 0.001). The groups did not vary statistically significant in terms of side effects or hemodynamic instability. Conclusion: Adjuvants such as dexmedetomidine or magnesium sulfate along with hyperbaric bupivacaine, for abdominal hysterectomy under spinal anesthesia, provide effective anesthesia. Dexmedetomidine (10 μg) and magnesium sulfate (100 mg) both showed safe intrathecal adjuvant usage. Remarkably, dexmedetomidine surpasses magnesium sulfate by swiftly inducing sensory and motor blocks, extending their duration, and enhancing analgesia. Notably, both adjuncts yield no adverse effects. Overall, these findings underscore the potential of dexmedetomidine as a more effective adjuvant in spinal anesthesia protocols for abdominal hysterectomy procedures.