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Indian Journal of Anesthesia and Analgesia

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Comparative Study between Intrathecal Dexmedetomidine and Intrathecal Magnesium Sulphate as an Adjunct to Bupivacaine in Spinal Anesthesia for Lower Limb Orthopaedic Surgeries

Saurav Shekhar, Senior Resident, Department of Anesthesia and Critical Care, Indira Gandhi Institute of Medical Sciences, Patna, Bihar 800014, India. , Saurav Shekhar1 , Ranjeet Rana De1 , Ajit Gupta2 , Harshwardhan1 , Shashank Dhiraj1 , Rajnish Kumar3

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Indian Journal of Anesthesia and Analgesia 4(3):p 822-826, July - September 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.44

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Abstract

Introduction: In order to maximize quality of anesthesia and effective analgesia, a number of adjuvants have been added to intrathecal local anesthetics but none of them have yet been identified without any adverse events. Material & Methods: 90 patients scheduled for lower limb orthopaedic surgery under spinal anaesthesia were included in this prospective randomized double blind study. Patients were randomly allocated into any of three groups. Group A– Patients receiving 0.5% hyperbaric bupivacaine 3ml (15mg) + 0.1ml (10µg) dexmedetomidine hydrochloride. Group BPatients receiving 0.5% hyperbaric bupivacaine 3ml (15mg) + 0.1ml (50mg) magnesium sulphate. Group C – Patients receiving 0.5% hyperbaric bupivacaine 3ml (15mg) + 0.1ml normal saline as control. The onset time for sensory and motor block, the regression time for block, duration of effective analgesia, hemodynamic parameters and any adverse events were recorded at timely intervals. Results: The onset time of sensory and motor block was faster with Group A (2.16 and 3.30 min) as compared to Group C (3.72 and 4.88 min), whereas it was significantly prolonged with Group B (6.1 and 7.03 min). Duration of sensory and motor block was significantly prolonged with Group A (344.67 and 318.67 min) and to a lesser extent with Group B (273 and 246 min) when compared to control Group (195 and 169.5 min). The duration of effective analgesia was longer with Group A (375 min) and Group B (294.3 min) when compared with Group C (216 min). Conclusion: Addition of Dexmedetomidine as an adjuvant to hyperbaric Bupivacaine intrathecally leads to rapid onset and prolonged duration of anesthesia. With intrathecal Magnesium sulphate, the onset of block was delayed but the duration of block was prolonged although to a lesser extent. Duration of effective analgesia was prolonged in both the study groups although more pronounced with Dexmedetomidine. Hemodynamic parameters where stable in all the three study groups without any significant group specific side effects.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.44

Keywords

Bupivacaine; Dexmedetomidine; Magnesium Sulphate; Spinal Anesthesia; Orthopaedic Surgery 

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