English

Abstract

BACKGROUND: Various adjuvants are being used with local anaesthetics in spinal anaesthesia for prolongation of intraoperative and post-operative analgesia. Dexmedetomidine, a highly selective α2 adrenergic agonist is a new neuroaxial adjuvant gaining popularity. AIMS: To evaluate the onset and duration of sensory and motor block, hemodynamic effect, post-operative analgesia and adverse effects of dexmedetomidine given intrathecally with hyperbaric 0.5% bupivacaine. METHODOLOGY: A study was carried out in 30 adult female patients aged 18-55 yrs of ASA grade I and II in each group scheduled for Total abdominal hysterectomy under spinal anaesthesia. Group B received 2.5ml of 0.5% hyperbaric bupivacaine with 0.5ml of normal saline. Group D received 2.5ml of 0.5% hyperbaric bupivacaine with 10µg of dexmedetomidine in 0.5ml of normal saline. The onset time to reach peak sensory and motor level, regression time of sensory and motor block, rescue analgesia, hemodynamic changes and side effects were recorded. STATISTICAL ANALYSIS USED: Data obtained were tabulated and analyzed using statistical package for social science (SPSS 16.0 evaluation version) to calculate the sample size. Descriptive data are presented as Mean ± SD and Continuous data are analyzed by unpaired't' test. P<0.05 was considered statistically significant. RESULTS: Patients in dexmedetomidine group (group D) had a significantly longer sensory and motor block than patients in bupivacaine group (group B). The mean time of sensory regression to S1 was (323 ± 31 min) in group D and (191 ± 15min) in group B. The regression time of motor block to reach Bromage 0 was (314 ± 30 min) in group D and (163 ± 15 min) in group B. The time to rescue analgesia was significantly longer in group D (383 ± 38 min) as compared to group B (228.6 ± 15 min). CONCLUSION: Intrathecal dexmedetomidine as adjuvant to spinal bupivacaine is associated with prolonged sensory and motor block, hemodynamic stability and reduced demand of rescue analgesia in twenty four hours.