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Indian Journal of Anesthesia and Analgesia

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Intrathecal Dexmeditomedine as an Adjuvant with Bupivacaine for Spinal Anesthesia in Infra Umbilical Surgeries

Annasaheb Maske, Assistant Professor, Department of Anesthesiology, JIIU‘s Indian Institute of Medical Science & Research (IIMSR) Medical College and Hospital, Warudi, Jalna431202, Maharastra, India. , Ashok Deshmukh1 , Annasaheb Maske1 , Arvindanand Rajgure2

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Indian Journal of Anesthesia and Analgesia 4(4):p 957-963, October-December 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.7

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Abstract

Introduction: For lower abdominal and lower limb surgeries the neuraxial blockade is the preferred mode of anesthesia. In recent years, use of intrathecal adjuvants like dexmedetomidine has gained popularity with the aim of prolonging the duration of the block, better success rate, and patient satisfaction, decreased resource utilization compared with general anesthesia and faster recovery and adequate postoperative pain management. The present study was aimed to evaluate the role of dexmedetomidine when added to heavy bupivacaine 0.5% intrathecally. Material and Methods: A doubleblinded randomized controlled trial conducted on 76 patients undergoing infraumbilical surgery, during the period from 1st of January 2016 till December 2016. Patients were randomly divided into one of two groups. The first group (A) received the drug (Dexmedetomidine) with Bupivacaine while the second group (B) received Bupivacaine plus saline. Results: The mean SBP was lower among group (A) 132.9 ± 11.0 mmHg compared to group (B) 143.0 ± 10.3 mmHg and mean DBP was significantly lower among group (A) 78.7 ± 11.1mmHg compared to group (B) 82.3 ± 12.1mmHg at all recorded timing intraoperatively. The mean time to reach T8 sensory level was 3.8±1.0 min and mean time to Bromage 3, was 11.9±1.8 min that is less than group B, 4.2±1.2 min and 13.1±2.2 min respectively. Analgesia requirements were significantly lowered among group (A) as compared to group (B).The most frequent complications observed among the group (A) were sedation 15(39.47%), bradycardia 12 (31.57%) and hypotension 18 (47.36%). Conclusion: It was concluded that adding Dexmedetomidine along with local anesthetic provides adequate sensory and motor block, reduces intraoperative and postoperative analgesic requirements, and reduces postop complications with no sedation or neurologic complications.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.7

Keywords

Intrathecal; Dexmedetomidine; Spinal Anesthesia; Adjuvants. 

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