Title: A Randomised Double Blind Comparative Study of Effects of Intrathecal Versus Intravenous Dexmedetomidine as an Adjuvant to Bupivacaine for Spinal Anaesthesia in Lower Limb Orthopaedic Surgeries
Authors: Juberahamad Rajjak Attar, Naseema Kanase, Kunda Dimble, Soudamini Gandhi, Bilal Mohammad, Tushar Munnoli, Vivek Dokania
DOI: https://dx.doi.org/10.18535/jmscr/v5i1.85
Abstract
Background: Various adjuvants have been used with local anaesthetics to prolong duration and provide post-operative analgesia of spinal anaesthesia. Dexmedetomidine the selective alpha 2 agonist is being currently used as adjuvant to spinal anaesthesia. Objective of study is to assess the effect of dexmedetomidine on onset and duration of anaesthesia and postoperative analgesia.
Method: Sixty patients scheduled for elective lower limb orthopaedic surgeries under spinal anaesthesia belonging to ASA I and ASAII were randomly divided into two groups of thirty each with double blind randomised method.
GROUP IT (Intrathecal)-0.5%hyperbaric bupivacaine 15mg with dexmedetomidine 5 µg intrathecally.
GROUP IV (Intravenous)-0.5% hyperbaric bupivacaine 15mg intrathecally with dexmedetomidine intravenously.
Time of onset and duration of sensory and motor blockade, hemodynamic parameters in perioperative period, time of first requirement of analgesia were observed.
Result: Sensory and motor duration time is significantly longer in group IT than group IV. Duration of complete analgesia was longer in group IT than group IV. There was no significant difference between both the groups in respect to effective analgesia. There is no significant difference between intraoperative HR, SBP, and DBP in both groups. There is a significant difference between values of Ramasay sedation score at 10, 30 and 60minutes when group IT compared with group IV, while no significant difference exists at 0 and 90minutes. There is no significant difference between postoperative VAS and highest sensory level.
Conclusion: Intrathecal dexmedetomidine significantly prolongs the duration of sensory and motor block of bupivacaine spinal anaesthesia as compared to intravenous dexmedetomidine, with preserved hemodynamic stability.
