A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to Bupivacaine

Background: Various adjuvants have been used with local anesthetics in spinal anesthesia to avoid intraoperative visceral and somatic pain and to provide prolonged postoperative analgesia. Dexmedetomidine, the new highly selective α2-agonist drug, is now being used as a neuraxial adjuvant. The aim o...

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Main Authors: Rajni Gupta, Reetu Verma, Jaishri Bogra, Monica Kohli, Rajesh Raman, Jitendra Kumar Kushwaha
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2011-01-01
Series:Journal of Anaesthesiology Clinical Pharmacology
Subjects:
Online Access:http://www.joacp.org/article.asp?issn=0970-9185;year=2011;volume=27;issue=3;spage=339;epage=343;aulast=Gupta
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author Rajni Gupta
Reetu Verma
Jaishri Bogra
Monica Kohli
Rajesh Raman
Jitendra Kumar Kushwaha
author_facet Rajni Gupta
Reetu Verma
Jaishri Bogra
Monica Kohli
Rajesh Raman
Jitendra Kumar Kushwaha
author_sort Rajni Gupta
collection DOAJ
description Background: Various adjuvants have been used with local anesthetics in spinal anesthesia to avoid intraoperative visceral and somatic pain and to provide prolonged postoperative analgesia. Dexmedetomidine, the new highly selective α2-agonist drug, is now being used as a neuraxial adjuvant. The aim of this study was to evaluate the onset and duration of sensory and motor block, hemodynamic effect, postoperative analgesia, and adverse effects of dexmedetomidine or fentanyl given intrathecally with hyperbaric 0.5% bupivacaine. Materials and Methods: Sixty patients classified in American Society of Anesthesiologists classes I and II scheduled for lower abdominal surgeries were studied. Patients were randomly allocated to receive either 12.5 mg hyperbaric bupivacaine plus 5 μg dexmedetomidine (group D, n=30) or 12.5 mg hyperbaric bupivacaine plus 25 μg fentanyl (group F, n=30) intrathecal. Results: Patients in dexmedetomidine group (D) had a significantly longer sensory and motor block time than patients in fentanyl group (F). The mean time of sensory regression to S1 was 476±23 min in group D and 187±12 min in group F (P<0.001). The regression time of motor block to reach modified Bromage 0 was 421±21 min in group D and 149±18 min in group F (P<0.001). Conclusions: Intrathecal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability, and reduced demand for rescue analgesics in 24 h as compared to fentanyl.
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spelling doaj.art-4f2fcba3a3104337b08148fbc4976f782022-12-21T18:33:04ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852011-01-0127333934310.4103/0970-9185.83678A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to BupivacaineRajni GuptaReetu VermaJaishri BograMonica KohliRajesh RamanJitendra Kumar KushwahaBackground: Various adjuvants have been used with local anesthetics in spinal anesthesia to avoid intraoperative visceral and somatic pain and to provide prolonged postoperative analgesia. Dexmedetomidine, the new highly selective α2-agonist drug, is now being used as a neuraxial adjuvant. The aim of this study was to evaluate the onset and duration of sensory and motor block, hemodynamic effect, postoperative analgesia, and adverse effects of dexmedetomidine or fentanyl given intrathecally with hyperbaric 0.5% bupivacaine. Materials and Methods: Sixty patients classified in American Society of Anesthesiologists classes I and II scheduled for lower abdominal surgeries were studied. Patients were randomly allocated to receive either 12.5 mg hyperbaric bupivacaine plus 5 μg dexmedetomidine (group D, n=30) or 12.5 mg hyperbaric bupivacaine plus 25 μg fentanyl (group F, n=30) intrathecal. Results: Patients in dexmedetomidine group (D) had a significantly longer sensory and motor block time than patients in fentanyl group (F). The mean time of sensory regression to S1 was 476±23 min in group D and 187±12 min in group F (P<0.001). The regression time of motor block to reach modified Bromage 0 was 421±21 min in group D and 149±18 min in group F (P<0.001). Conclusions: Intrathecal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability, and reduced demand for rescue analgesics in 24 h as compared to fentanyl.http://www.joacp.org/article.asp?issn=0970-9185;year=2011;volume=27;issue=3;spage=339;epage=343;aulast=GuptaBupivacainedexmedetomidinefentanylspinal anaesthesia
spellingShingle Rajni Gupta
Reetu Verma
Jaishri Bogra
Monica Kohli
Rajesh Raman
Jitendra Kumar Kushwaha
A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to Bupivacaine
Journal of Anaesthesiology Clinical Pharmacology
Bupivacaine
dexmedetomidine
fentanyl
spinal anaesthesia
title A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to Bupivacaine
title_full A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to Bupivacaine
title_fullStr A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to Bupivacaine
title_full_unstemmed A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to Bupivacaine
title_short A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to Bupivacaine
title_sort comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to bupivacaine
topic Bupivacaine
dexmedetomidine
fentanyl
spinal anaesthesia
url http://www.joacp.org/article.asp?issn=0970-9185;year=2011;volume=27;issue=3;spage=339;epage=343;aulast=Gupta
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