English

Abstract

BACKGROUND: Intrathecal adjuvants have gained popularity with the aim of prolonging the duration of block and quality of analgesia. Dexmedetomidine is relatively selective alpha2-agonist with sympatholytic, sedative, amnestic and analgesic properties. The study is designed to evaluate the efficacy of intrathecal administration of different doses of dexmedetomidine on duration of subarachnoid block and postoperative analgesia. METHODS: 60 female patients scheduled for hysterectomy, randomized in 3 groups of 20 each. Each patient was given 2.5ml of 0.5% bupivacaine with 5μg of dexmedetomidine in Group-A, 7.5μg in Group-B and 12μg in Group-C. Onset and regression time of sensory and motor block, hemodynamic change, sedation score, requirement of rescue analgesics and incidence of adverse effects were assessed perioperatively upto 24hours. RESULTS: Demographic data was statistically comparable. Sensory block onset was statistically highly significant between Group-A & C and Group-B & C (p>0.05). The time for 2 segment sensory regression and bromage scale 0 was increased by adding dexmedetomidine in a dose dependent manner (p<0.001).Postoperative VAS and analgesic requirement was significantly lower in Group-C (p<0.001). Sedation scores were significantly higher in Group-C (p<0.05). A significant decrease in heart rate and blood pressure was observed by increasing dose of dexmedetomidine with respect to base line in all the three groups. However, the results were comparable on intergroup analysis. CONCLUSION: Dexmedetomidine when used as an adjuvant to intrathecal bupivacaine hastens the onset of sensory block prolongs the duration of sensory and motor block in a dose dependent manner without any significant increase in side effects.