Abstract

Background and Aim: Lower abdominal surgeries today are done preferentially under subarachnoid block. The relatively short duration of analgesia is a limiting factor which is overcome by adding an adjuvant to intrathecal bupivacaine.Adjuvants have been helpful in induction of early ambulation but at the cost of their associated adverse effects. We aimed to compare two different doses of dexmedetomidine as adjuvant to 0.5% hyperbaric Bupivacaine in abdominal hysterectomy. Material and Methods: It was a prospective, double-blind study among 60 patients posted for abdominal hysterectomy under spinal anaesthesia. The patients were randomly allocated to 2 groups (Group D1 and Group D2) of 30 each. Group D1 received hyperbaric Bupivacaine (15 mg) with Dexmedetomidine (5 µg). Group D2 received hyperbaric bupivacaine (15 mg) with Dexmedetomidine (10 µg). The onset time of sensory and motor block, regression time of sensory and motor block, duration of analgesia, hemodynamic 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 hemodynamic changes and adverse effects of Dexmedetomidine were also recorded. Results: Onset of sensory block was 3.16 ± 0.37 minutes in Group D2 as compared to 4.80 ± 0.74 minutes in Group D1 with total duration of sensory block as 355.35 ± 11.83 minutes in Group D2 and 257.77 ± 18.43 minutes in Group D1. Similarly, the onset of motor block was 4.12 ± 0.34 minutes and 4.74 ± 0.71 minutes, with total duration of motor block as 324.67 ± 22.15 minutes and 225.41 ± 17.20 minutes in Group D2 and in Group D1 respectively. Duration of analgesia was360.19 ± 16.38 minutes with Dexmedetomidine 10 µg but 302.06 ± 17.36 minutes in Dexmedetomidine 5 µg group. Conclusions: Addition of 10 µg of Dexmedetomidine to 0.5% hyperbaric Bupivacaine 15mg (3 mL) in spinal anaesthesia significantly decreases the onset time, prolongs the duration of both sensory and motor blockade, improves the quality of postoperative analgesia with better hemodynamic stability as compared to bupivacaine with 5 µg Dexmedetomidine.

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