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Effect of Dexmedetomidine as an Adjuvant to Neuraxial Block with Bupivacaine in Lower Abdominal and Lower Limb Surgeries

Geeta Karki , Dheeraj Saxena1 , Geeta Karki2

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Indian Journal of Anesthesia and Analgesia 6(5):p 1743-1749, September-October 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6519.36

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Dheeraj Saxena, Geeta Karki. Effect of Dexmedetomidine as an Adjuvant to Neuraxial Block with Bupivacaine in Lower Abdominal and Lower Limb Surgeries. Indian J Anesth Analg. 2019;6(5 P-II):1743-1749.


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Abstract

Background: The local anesthetics are associated with relatively short duration of action which limit the technique for comparatively long duration surgery and also analgesic intervention is needed in postoperative period. Dexmedetomidine, the new highly selective α2-agonist drug, is now being used as a neuraxial adjuvant. The aim of this study was to evaluate the onset and duration of sensory and motor block hemodynamic effect, postoperative analgesia, and adverse effects of dexmedetomidine given intrathecally with hyperbaric 0.5% bupivacaine. Materials and Methods: The study was carried out on 60 patients of both the sexes of ASA Grade I and II physical status scheduled for lower abdominal and lower limb surgeries. Patients were allocated into two groups. Group I (Control): 15 mg hyperbaric bupivacaine + 0.5 ml saline (preservative free). Group II (Dexmedetomidine): 15 mg hyperbaric bupivacaine + 10 μg Dexmedetomidine. Results: Patients in dexmedetomidine group (II) had a significantly longer sensory and motor block time than patients in control Group (I). The mean time of sensory regression to S1 was 367 ± 32 min in group II and 204 ± 21 min in Group I. The regression time of motor block to reach modified Bromage 0 was 325 ± 21 min in group II and 138 ± 15 min in Group I. Conclusions: Intrathecal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability, and reduced demand for rescue analgesics.


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Dheeraj Saxena, Geeta Karki. Effect of Dexmedetomidine as an Adjuvant to Neuraxial Block with Bupivacaine in Lower Abdominal and Lower Limb Surgeries. Indian J Anesth Analg. 2019;6(5 P-II):1743-1749.


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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6519.36

Keywords

Dexmedetomidine; Neuraxial Block; Bupivacaine; Intrathecal; VAS (visual analogue score).

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