Hemodynamic and analgesic effect of intrathecal dexmedetomidine with low dose hyperbaric bupivacaine in spinal anaesthesia, caesarean section: a randomized controlled trial
Objectives: Hypotension is the major side effect of spinal anaesthesia during caesarean section. Since the adverse effects are dosage-dependent, various methods have been tried to prevent spinal anaesthesia induced complications, such as lowering the local anaesthetic dose and combining it with addi...
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| Format: | Article |
| Language: | English |
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Barpeta Obstetrics and Gynaecological Society
2023-08-01
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| Series: | New Indian Journal of OBGYN |
| Subjects: | |
| Online Access: | http://journal.barpetaogs.co.in/pdf/01093.pdf |
| _version_ | 1827878186530111488 |
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| author | Plabon Hazarika Tapan Kumar Talukdar Jagadish Basumatary Dilip Kumar Saloi |
| author_facet | Plabon Hazarika Tapan Kumar Talukdar Jagadish Basumatary Dilip Kumar Saloi |
| author_sort | Plabon Hazarika |
| collection | DOAJ |
| description | Objectives: Hypotension is the major side effect of spinal anaesthesia during caesarean section. Since the adverse effects are dosage-dependent, various methods have been tried to prevent spinal anaesthesia induced complications, such as lowering the local anaesthetic dose and combining it with additives like neuraxial opioids, alpha-2 agonist e.g. dexmedetomidine. Here we are investigating the efficacy dexmedetomidine with hyperbaric bupivacaine for improved postoperative analgesia and more stable hemodynamic during caesarean section. Methodology: An institutional-based RCT was conducted on 60 patients randomly allocated in two groups. Low dose hyperbaric bupivacaine L-DG group (n=30) received 7.5 mg hyperbaric bupivacaine with 5µgm dexmedetomidine and control group S-CG (n=30) received standard dose of hyperbaric bupivacaine of 12.5mg. The hemodynamic parameters, postoperative analgesia, other adverse effects and neonatal outcomes were monitored. Result: The L-DG group had significantly more rapid and persistent sensory block (p < 0.05), stable maternal hemodynamic which was maintained by fewer IV fluids (p < 0.01), lower vasopressor dosages (p < 0.01), no evidence of foetal distress, and a lower incidence of postoperative maternal shivering. Post operative duration of analgesia in L-DG group was more significant (p < 0.001). Conclusion: L-DG group shows stable maternal hemodynamic with fewer demands for vasopressors and fluids, effective sensory blockade and excellent postoperative analgesia. |
| first_indexed | 2024-03-12T17:47:50Z |
| format | Article |
| id | doaj.art-b627df1c86014e5ea8520de7566668d6 |
| institution | Directory Open Access Journal |
| issn | 2454-2334 2454-2342 |
| language | English |
| last_indexed | 2024-03-12T17:47:50Z |
| publishDate | 2023-08-01 |
| publisher | Barpeta Obstetrics and Gynaecological Society |
| record_format | Article |
| series | New Indian Journal of OBGYN |
| spelling | doaj.art-b627df1c86014e5ea8520de7566668d62023-08-03T11:24:17ZengBarpeta Obstetrics and Gynaecological SocietyNew Indian Journal of OBGYN2454-23342454-23422023-08-01101939810.21276/obgyn.2023.10.1.16Hemodynamic and analgesic effect of intrathecal dexmedetomidine with low dose hyperbaric bupivacaine in spinal anaesthesia, caesarean section: a randomized controlled trialPlabon Hazarika 0Tapan Kumar Talukdar 1Jagadish Basumatary2Dilip Kumar Saloi 3Assistant Professor, Department of Anaesthesiology, Tezpur Medical College, Tezpur, Assam, IndiaAssistant Professor, Department of Anaesthesiology, Tezpur Medical College, Tezpur, Assam, IndiaAssociate Professor, Department of Anaesthesiology, Tezpur Medical College, Tezpur, Assam, IndiaProfessor, Department of Anaesthesiology, Tezpur Medical College, Tezpur, Assam, IndiaObjectives: Hypotension is the major side effect of spinal anaesthesia during caesarean section. Since the adverse effects are dosage-dependent, various methods have been tried to prevent spinal anaesthesia induced complications, such as lowering the local anaesthetic dose and combining it with additives like neuraxial opioids, alpha-2 agonist e.g. dexmedetomidine. Here we are investigating the efficacy dexmedetomidine with hyperbaric bupivacaine for improved postoperative analgesia and more stable hemodynamic during caesarean section. Methodology: An institutional-based RCT was conducted on 60 patients randomly allocated in two groups. Low dose hyperbaric bupivacaine L-DG group (n=30) received 7.5 mg hyperbaric bupivacaine with 5µgm dexmedetomidine and control group S-CG (n=30) received standard dose of hyperbaric bupivacaine of 12.5mg. The hemodynamic parameters, postoperative analgesia, other adverse effects and neonatal outcomes were monitored. Result: The L-DG group had significantly more rapid and persistent sensory block (p < 0.05), stable maternal hemodynamic which was maintained by fewer IV fluids (p < 0.01), lower vasopressor dosages (p < 0.01), no evidence of foetal distress, and a lower incidence of postoperative maternal shivering. Post operative duration of analgesia in L-DG group was more significant (p < 0.001). Conclusion: L-DG group shows stable maternal hemodynamic with fewer demands for vasopressors and fluids, effective sensory blockade and excellent postoperative analgesia.http://journal.barpetaogs.co.in/pdf/01093.pdfdexmedetomidinebupivacainecaesarean sectionhypotensionspinal aesthesia |
| spellingShingle | Plabon Hazarika Tapan Kumar Talukdar Jagadish Basumatary Dilip Kumar Saloi Hemodynamic and analgesic effect of intrathecal dexmedetomidine with low dose hyperbaric bupivacaine in spinal anaesthesia, caesarean section: a randomized controlled trial New Indian Journal of OBGYN dexmedetomidine bupivacaine caesarean section hypotension spinal aesthesia |
| title | Hemodynamic and analgesic effect of intrathecal dexmedetomidine with low dose hyperbaric bupivacaine in spinal anaesthesia, caesarean section: a randomized controlled trial |
| title_full | Hemodynamic and analgesic effect of intrathecal dexmedetomidine with low dose hyperbaric bupivacaine in spinal anaesthesia, caesarean section: a randomized controlled trial |
| title_fullStr | Hemodynamic and analgesic effect of intrathecal dexmedetomidine with low dose hyperbaric bupivacaine in spinal anaesthesia, caesarean section: a randomized controlled trial |
| title_full_unstemmed | Hemodynamic and analgesic effect of intrathecal dexmedetomidine with low dose hyperbaric bupivacaine in spinal anaesthesia, caesarean section: a randomized controlled trial |
| title_short | Hemodynamic and analgesic effect of intrathecal dexmedetomidine with low dose hyperbaric bupivacaine in spinal anaesthesia, caesarean section: a randomized controlled trial |
| title_sort | hemodynamic and analgesic effect of intrathecal dexmedetomidine with low dose hyperbaric bupivacaine in spinal anaesthesia caesarean section a randomized controlled trial |
| topic | dexmedetomidine bupivacaine caesarean section hypotension spinal aesthesia |
| url | http://journal.barpetaogs.co.in/pdf/01093.pdf |
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