Intravenous versus intrathecal dexmedetomidine as an additive to hyperbaric bupivacaine in spinal anesthesia for hip arthroplasty. A randomized controlled trial
Background This study aimed to assess the safety and efficacy of intravenous (IV) versus intrathecal (IT) dexmedetomidine as an additive to hyperbaric bupivacaine in spinal anesthesia in adult patients undergoing hip arthroplasty.Methods This randomized, controlled, triple-blinded trial enrolled 90...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2022.2085974 |
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| author | Abdelrhman Alshawadfy Mohamed A. Elsadany Amira Mahfouz Elkeblawy Ahmed A. El-Lilly |
| author_facet | Abdelrhman Alshawadfy Mohamed A. Elsadany Amira Mahfouz Elkeblawy Ahmed A. El-Lilly |
| author_sort | Abdelrhman Alshawadfy |
| collection | DOAJ |
| description | Background This study aimed to assess the safety and efficacy of intravenous (IV) versus intrathecal (IT) dexmedetomidine as an additive to hyperbaric bupivacaine in spinal anesthesia in adult patients undergoing hip arthroplasty.Methods This randomized, controlled, triple-blinded trial enrolled 90 patients aged 18–65 years, American Society of Anesthesiologists physical status I–II who were scheduled for hip arthroplasty under spinal anesthesia. The study subjects were randomly assigned into three groups. The control group (group C) received IT hyperbaric bupivacaine (0.5%, 12.5 mg) plus 1 ml of normal saline. The IT group received IT hyperbaric bupivacaine (0.5%, 12.5 mg) plus 5 µg of dexmedetomidine diluted in 1 ml of normal saline. The IV group received hyperbaric bupivacaine (0.5%, 12.5 mg) plus 0.5 µg/kg of dexmedetomidine diluted in 20 ml of normal saline administered slowly IV. A modified Bromage scale was used to assess motor blocks. We used the Numerical Pain rating scale (NRS) for pain assessment. We used morphine for postoperative analgesia.Results Groups IT and IV had significantly lower total morphine consumption and higher time to the first analgesic request than group C. Durations to two-segment regression and motor block regression to Bromage 1 were significantly higher in groups IT and IV than in group C. Motor block regression to Bromage 1 showed a significant difference between the IT and IV groups with a more delayed motor recovery in the IT group.Conclusion Both IV and IT dexmedetomidine extend the effect of the sensorimotor impact of subarachnoid anesthesia, but IT dexmedetomidine was superior to IV dexmedetomidine in adult patients undergoing hip arthroplasty. |
| first_indexed | 2024-12-12T07:36:17Z |
| format | Article |
| id | doaj.art-505bb61f0f004b228fbf1476c1fd3797 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-12-12T07:36:17Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-505bb61f0f004b228fbf1476c1fd37972022-12-22T00:32:55ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492022-12-0138134234810.1080/11101849.2022.2085974Intravenous versus intrathecal dexmedetomidine as an additive to hyperbaric bupivacaine in spinal anesthesia for hip arthroplasty. A randomized controlled trialAbdelrhman Alshawadfy0Mohamed A. Elsadany1Amira Mahfouz Elkeblawy2Ahmed A. El-Lilly3Department of Anesthesia and Intensive Care, Faculty of Medicine, Suez Canal University, Ismailia, EgyptDepartment of Anesthesia and Intensive Care, Faculty of Medicine, Suez Canal University, Ismailia, EgyptDepartment of Anesthesiology, Surgical Intensive Care, and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, EgyptDepartment of Anesthesia and Intensive Care, Faculty of Medicine, Suez Canal University, Ismailia, EgyptBackground This study aimed to assess the safety and efficacy of intravenous (IV) versus intrathecal (IT) dexmedetomidine as an additive to hyperbaric bupivacaine in spinal anesthesia in adult patients undergoing hip arthroplasty.Methods This randomized, controlled, triple-blinded trial enrolled 90 patients aged 18–65 years, American Society of Anesthesiologists physical status I–II who were scheduled for hip arthroplasty under spinal anesthesia. The study subjects were randomly assigned into three groups. The control group (group C) received IT hyperbaric bupivacaine (0.5%, 12.5 mg) plus 1 ml of normal saline. The IT group received IT hyperbaric bupivacaine (0.5%, 12.5 mg) plus 5 µg of dexmedetomidine diluted in 1 ml of normal saline. The IV group received hyperbaric bupivacaine (0.5%, 12.5 mg) plus 0.5 µg/kg of dexmedetomidine diluted in 20 ml of normal saline administered slowly IV. A modified Bromage scale was used to assess motor blocks. We used the Numerical Pain rating scale (NRS) for pain assessment. We used morphine for postoperative analgesia.Results Groups IT and IV had significantly lower total morphine consumption and higher time to the first analgesic request than group C. Durations to two-segment regression and motor block regression to Bromage 1 were significantly higher in groups IT and IV than in group C. Motor block regression to Bromage 1 showed a significant difference between the IT and IV groups with a more delayed motor recovery in the IT group.Conclusion Both IV and IT dexmedetomidine extend the effect of the sensorimotor impact of subarachnoid anesthesia, but IT dexmedetomidine was superior to IV dexmedetomidine in adult patients undergoing hip arthroplasty.https://www.tandfonline.com/doi/10.1080/11101849.2022.2085974Intravenousintrathecaldexmedetomidinespinal anesthesiahip arthroplasty |
| spellingShingle | Abdelrhman Alshawadfy Mohamed A. Elsadany Amira Mahfouz Elkeblawy Ahmed A. El-Lilly Intravenous versus intrathecal dexmedetomidine as an additive to hyperbaric bupivacaine in spinal anesthesia for hip arthroplasty. A randomized controlled trial Egyptian Journal of Anaesthesia Intravenous intrathecal dexmedetomidine spinal anesthesia hip arthroplasty |
| title | Intravenous versus intrathecal dexmedetomidine as an additive to hyperbaric bupivacaine in spinal anesthesia for hip arthroplasty. A randomized controlled trial |
| title_full | Intravenous versus intrathecal dexmedetomidine as an additive to hyperbaric bupivacaine in spinal anesthesia for hip arthroplasty. A randomized controlled trial |
| title_fullStr | Intravenous versus intrathecal dexmedetomidine as an additive to hyperbaric bupivacaine in spinal anesthesia for hip arthroplasty. A randomized controlled trial |
| title_full_unstemmed | Intravenous versus intrathecal dexmedetomidine as an additive to hyperbaric bupivacaine in spinal anesthesia for hip arthroplasty. A randomized controlled trial |
| title_short | Intravenous versus intrathecal dexmedetomidine as an additive to hyperbaric bupivacaine in spinal anesthesia for hip arthroplasty. A randomized controlled trial |
| title_sort | intravenous versus intrathecal dexmedetomidine as an additive to hyperbaric bupivacaine in spinal anesthesia for hip arthroplasty a randomized controlled trial |
| topic | Intravenous intrathecal dexmedetomidine spinal anesthesia hip arthroplasty |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2022.2085974 |
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