Evaluation of Dexmedetomidine as an Adjuvant to Intrathecal Bupivacaine in Infraumbilical Surgeries
Introduction: Various adjuvants like morphine, buprenorphine and fentanyl, clonidine, ketamine are being used in anaesthetic practice since long for improvement of peri-operative analgesia following spinal anaesthesia. Such adjuvants have been helpful in induction of early ambulation but at the...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/7379/17987_CE[Ra1]_F(GH)_PF1(Ro_Om)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: Various adjuvants like morphine, buprenorphine
and fentanyl, clonidine, ketamine are being used in anaesthetic
practice since long for improvement of peri-operative analgesia
following spinal anaesthesia. Such adjuvants have been helpful
in induction of early ambulation but at the cost of their associated
adverse effects. Therefore search for an effective adjuvant is
still going on. Currently Dexmedetomidine, a highly selective α2
-
adrenoreceptor agonist is being studied for its adjuvant action
in spinal anaesthesia.
Aim: The present study aims to evaluate the efficacy of
intrathecal Dexmedetomidine as an adjuvant to Bupivacaine
in spinal anaesthesia in patients undergoing infra-umbilical
surgeries.
Materials and Methods: It was a prospective, double blind
study among 60 patients undergoing infraumbilical surgeries
under spinal anaesthesia. The patients were randomly allocated
to 2 groups (Group I and Group II) of 30 each. Group I received
hyperbaric bupivacaine (15 mg) alone and Group II received
hyperbaric bupivacaine (15 mg) with Dexmedetomidine
(5mcg). The onset time of sensory and motor block, regression
time of sensory and motor block, duration of analgesia,
haemodynamic parameters were recorded both intra and
postoperatively. The primary efficacy parameters were to
determine the onset and duration of sensory block, motor
block and duration of postoperative analgesia. Secondarily
any associated haemodynamic changes and adverse effects of
Dexmedetomidine were also recorded.
Statistical Analysis: Continuous data were analysed using the
Student’s t-test and categorical variables by two-tailed Fisherexact test or Chi-square test.
Results: Onset of sensory block was 129.33±14.8 seconds
in Group II as compared to 208.33±19.18 seconds in Group I
with total duration of sensory block as 317.70±16.16 minutes
in Group II and 188±11.86 minutes in Group I. Similarly, onset
of motor block was 226.33±31.86 minutes and 320.33±29.81
minutes, with total duration of motor block as 286.33±15.15
minutes and 166.5±12.11 minutes in Group II and in Group I
respectively. Duration of analgesia was 333.6±20.67 minutes
with Dexmedetomidine but 193.67±7.06 minutes in bupivacaine
alone group.
Conclusion: Dexmedetomidine as an adjuvant had shown
early onset of sensory and motor block with longer duration of
analgesia and haemodynamic stability in the present study as
compared to bupivacaine alone. |
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| ISSN: | 2249-782X 0973-709X |