Abstract
Spinal anesthesia is used commonly intra operatively. However, local anesthetics are associated with relatively short duration of action. A number of adjuvants have been used to prolong the postoperative analgesia. Objectives: To evaluate role of dexmedetomidine added to heavy bupivacaine 0.5% intrathecally for lower abdominal surgeries. Subjects and methods: Sixty two patients were randomly divided into one of two group, Group (D) received 3.5 mL volume of 0.5% hyperbaric bupivacaine and 5 μg dexmedetomidine in 0.5 mL of preservative free normal saline intrathecally. Group (P) received 0.5 ml normal saline added to the same dose of heavy 0.5% bupivacaine and served as placebo. Results: There was significantly less time needed to reach T8 sensory level, 2-segment regression, and time to reach Bromage 3in group (D) compared to group (P). There was significantly more time needed for first requirement of analgesia in group (D) compared to group (P). There was a significantly less analgesic dose requirement in group (D) compared to group (P). Conclusion: Receiving Dexmedetomidine at a dose of 5 μg provides earlier sensory and motor blockade, less postoperative analgesic requirements, less shivering among patients of lower abdominal surgery under intrathecal anaesthesia with no sedation effect or neurologic complications.
Highlights
Spinal anesthesia is the most commonly used technique for lower abdominal and perineal surgeries
Local anesthetics-when used alone-is associated with relatively short duration of action, early analgesic intervention is needed in the postoperative period
Based on earlier human studies, it is hypothesized that intrathecal Dexmedetomidine would produce more postoperative analgesic effect with hyperbaric bupivacaine in spinal anaesthesia with minimal side effects [4,5]
Summary
Spinal anesthesia is the most commonly used technique for lower abdominal and perineal surgeries. Local anesthetics-when used alone-is associated with relatively short duration of action, early analgesic intervention is needed in the postoperative period. A number of adjuvants have been used to prolong the postoperative analgesia [1,2]. Dexmedetomidine, a new highly selective α2-agonist, is under evaluation as a neuraxial adjuvant. It provides stable hemodynamic condition, good quality of intra-operative analgesia and prolonged post-operative analgesia with minimal side effects [3]. Based on earlier human studies, it is hypothesized that intrathecal Dexmedetomidine would produce more postoperative analgesic effect with hyperbaric bupivacaine in spinal anaesthesia with minimal side effects [4,5]
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