Effect of intravenous versus intrathecal dexmedetomidine on the characteristic of spinal anesthesia in patients undergoing infra umbilical surgeries

Abstract

Background: Dexmedetomidine have been used as an adjuvant to local anaesthetic in subarachnoid block and as intravenous medication for postoperative pain relief and sedation. In higher doses, it may produce adverse effect on haemodynamic. Aim: This study compares the effects of low-dose intravenous (IV) dexmedetomidine or Intrathecal dexmedetomidine with hyperbaric bupivacaine on spinal characteristic, total duration of analgesia, and sedation. Objective: the primary objective of our study evaluate the total duration of analgesia and a secondary objective was to assess and compare the onset time and duration of sensory block, changes in hemodynamic parameter and side effect. Materials and Methods: In this prospective, randomised, double-blinded study, 240 American Society of Anaesthesiologist Status I and II patients were randomly allocated into two groups: Group IV: Patients received dexmedetomidine 0.5 μg/kg body weight diluted up to 10 ml with normal saline intravenously by infusion pump and 3 ml of 0.5% hyperbaric bupivacaine diluted in 0.5 ml of normal saline intrathecally.Group IT: Patients received 10 ml of normal saline intravenously by infusion pump and 3 ml of 0.5% hyperbaric bupivacaine with 0.5 ml (5 μgm) of dexmedetomidine intrathecally. Onset and duration of sensory and motor block, first request for analgesia, hemodynamic, VAS score, and sedation score were assessed. Results: Time to two segment regression was more in group IT (127.7 ± 16.69 min) as compared to group IV (116 ± 16.2 min). Total duration of analgesia was also prolonged in group IT (274.68 ± 58.21 min) than group IV (211.37 ± 32.87 min)(P