Study to compare the effect of Dexmedetomidine vs MgSo4 (50%) intrathecally as an adjuvant with bupivacaine (0.5%) for lower limb orthopedic surgery under subarachnoid block

Abstract

Lower limb surgeries may be performed under local, regional (spinal or epidural) or general anesthesia, but neuraxial blockade is the preferred mode of anesthesia. Sub-arachnoid block or Spinal anaesthesia is the most common central block used in a surgical setting, which is being the most versatile and commonly used regional block. With increasing use of hyperbaric bupivacaine for sub arachnoid block, their limitations like prolongation of onset of sensory and motor blockage effect, short duration of action and early postoperative requirement of an analgesic agent, require an intrathecal adjuvant to these local anaesthetic agents for a complete satisfactory period of anaesthesia and patient satisfaction. The aim of this study was to compare and evaluate the effect of Dexmedetomidine with MgSO4 (50%) intrathecally as an adjuvant for the characteristics of sensory and motor blockage for lower limb orthopedic surgery under subarachnoid block along with bupivacaine (0.5%). : Participants were randomly divided into two groups of 40 participants each. Group D (n=40) received Bupivacaine + dexmedetomidine, Group M (n=40) received Bupivacaine + MgSO4. Under strict aseptic and antiseptic precaution subarachnoid block was performed. Mixture of drugs according to group assign was injected. Assessment of sensory and motor characteristics was done. Inj. Dexmedetomidine as an adjuvant in spinal block, seems to be superior to intra-thecal MgSO4 as it has faster onset, longer duration of action, prolonged analgesia in comparison with Magnesium Sulphate without significant hemodynamic alterations. Dexmedetomidine, as an adjuvant to Inj. Bupivacaine intra-thecally in sub-arachnoid block, has faster onset, longer duration of action, prolonged analgesia in comparison with Magnesium Sulphate.