Title: Lower Dose of Hyperbaric Bupivacaine with Dexmeditomedine and Conventional Dose of Hyperbaric Bupivacaine for Subarachnoid Block in Lower Limb Surgeries (Orthopaedic Cases) - A Comparative Study
Authors: Dr Ajith Kumar G, Dr Geethakumari. P, Dr R.S. Usha Devi
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.219
Abstract
Background and aims: It is universally agreed that the anaesthesia of choice for lower limb surgeries is a subarachnoid block and a sensory level of T – 10 is recommended to provide excellent anaesthesia for the patient. It is well established that opioids has got a prominent analgesic action at the spinal cord level and it can be used safely for subarachnoid block. If you can add a α-2 adrenoreceptor agonist like Dexmeditomedine to hyperbaric bupivacaine (the standard drug used for sub arachnoid block) and thus reduce the dose of bupivacaine used, without compromising on the analgesic effect.
aim of the study: Primary aim: To measure analgesic efficacy in terms of duration of analgesia by adding dexmeditomedine to lower dose Hyperbaric bupivacaine.
Secondary aim: To compare side effects such as nausea, vomiting, bradycardia, hypotension, sedation, shivering and pruritis.
Methods: This study was prospective, randomized, comparative study double blind in nature and conducted after obtaining institutional Ethics Committee approval and written informed consent. The person giving the drug and the monitoring personnel were blinded 60 adult patients of ASA grade I and II aged between 20 – 50 year. Undergoing various elective lower limb (Orthopaedics) surgeries.
Results: Dexmeditomedine in a dose of 5µg was used for supplementation spinal Bupivacaine, showed the duration of sensory block in study group (Dexmeditomedine) is 295+40 min and control group bupavacaine 219±15 (P< 0.001) and it is highly significant.
Conclusion: 5 µg Dexmeditomedine to 2cc of hyperbaric Bupivacaine 0.5% is associated with lessor incidence of Hypotension and lessor degree of motor blockade but with prolonged sensory block.
Keywords: Dexmeditomedine, Hyperbaric Bupivacaine, Spinal anaesthesia.
