Title: Effect of Intravenous Dexmedetomidine on the Action of Spinal Bupivacaine in Comparision with Intravenous Midazolam
Authors: D. Suresh Chander, S J V Kameswararao*, J Santosh Kumar, P Upendar Gowd
DOI: http://dx.doi.org/10.18535/jmscr/v3i8.66
DIDS : 08.2015-XXXXXXX
Background: The present study was designed to evaluate the effect of intravenous dexmedetomidine on the action of spinal bupivacaine in comparision with intravenous midazolam. Materials and methods: Study was done for a period of 8 months in total 50 patients, first group are of 25 patients receiving intravenous Dexmedetomidine 0.5 micrograms/kg (n = 25). The second group are controls of 25 patients receiving intravenous midazolam 0.05milligrams/kg (n = 25). Results: Duration of sensory blockade and motor blockade was prolonged with the use of intravenous dexmedetomidine premedication in comparison with intravenous midazolam. Good sedation levels, patient’s cooperation and better operating conditions for the surgeon without significant respiratory depression were achieved, intra operative risk of bradycardia was more clear and significant with dexmedetomidine than with midazolam. Post operative analgesia was significantly prolonged with the use of intravenous dexmedetomidine premedication than with intravenous midazolam. Conclusion: Supplementation of spinal anesthesia with intravenous dexmedetomidine produces significantly longer sensory and motor block than intrathecal bupivacaine alone Key words: Dexmedetomidine , Bupivacaine, Midazolam Tamsen A, Gordh T. Epidural clonidine produces analgesia. Lancet. 1984;2:231–232. Clarke KW, Hall LW. “Xylazine”—a new sedative for horses and cattle. Vet Rec. 1969;85:512–517. Korkmaz M, Gurbet A, Sahin S: Comparision of sedative effects of midazolam and dexmedetomidine during regional anesthesia. Dicle med j 2011; 38: 148-154. Hong JY, Kim WO, Yoon Y, Chol Y, Kimsh KL: acta anesthesiol scandal2012; 56: 382-387. Jorm CM, Stamford JA: Actions of the hypnotic anaesthetic, dexmedetomidine, on noradrenaline release and cell firing in rat locus coeruleus slices. Br J Anaesth; 1993, 71: 447-9. Roberts L: Dexmedetomidine. J Pharm Soc Wis; November/December 2003, 47-52. Ebert TJ, Hall JE, Barney JA, Ulrich TD, Colinco MD: The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology; 2000, 93:382-94. Memis¸ D, Turan A, Karamanlioglu B, Pamukcu Z, Kurt I. Adding dexmedetomidine to lidocaine for intravenous regional anesthesia. Anesth Analg 2004; 98: 835–40. Grant SA, Breslin DS, MacLeod DB, Gleason D, Martin G. Dexmedetomidine infusion for sedation during fiberoptic intubation: a report of three cases. J Clin Anesth 2004; 16: 124–6. Ebert TJ, Hall JE, Barney JA, Uhrich TD, Colinco MD. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology 2000; 93: 382–94. Rhee K, Kang K, Kim J, Jeon Y. Intravenous clonidine prolongs bupivacaine spinal anesthesia. Acta Anaesthesiol Scand 2003; 47: 1001–5. NivD, Davidovich S, Geller E, UrcaG. Analgesic and hyperalgesiceffects of midazolam: dependence on route of administration. Anesth Analg 1988; 67: 1169–73. Ho KM, Ismail H. Use of intrathecal midazolam to improve perioperative analgesia: a meta-analysis. Anaesth Intensive Care 2008; 36: 365–73. Ghai B, Makkar JK, Chari P, Rao KL. Addition of midazolam to continuous postoperative epidural bupivacaine infusion reduces requirement for rescue analgesia in children undergoing upper abdominal and flank surgery. J Clin Anesth 2009; 21: 113–9. Al-Metwalli RR, Mowafi HA, Ismail SA, Siddiqui AK, Al-Ghamdi AM, Shafi MA, El-Saleh AR: Effect of intra-articular dexmedetomidine on postoperative analgesia after arthroscopic knee surgery. Br JAnaesth; 2008 Jun 20. Povey HM, Jacobsen J, Westergaard-Nielsen J: Subarachnoid analgesia with hyperbaric 0.5% bupivacaine. Effect of a 60-min period of sitting. Acta Anesthesiol Scand; 1989, 33:(4):295-7. Jaakola ML, Salonen M, Lehtinen R, Scheinin H. The analgesic action of dexmedetomidine—a novel alpha 2-adrenoceptor agonist— in healthy volunteers. Pain 1991; 46: 281–5Abstract
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