Abstract
Background: Spinal anesthesia is commonly used in lower limb surgeries .Central mechanisms have been proposed to explain the prolongation of effect reported with the off-label use of dexmedetomidine as an adjuvant in local anesthetic admixtures. We evaluated whether IV dexmedetomidine can prolong the duration of sensory block associated with spinal anesthesia.
Objective: To evaluate the effect of intravenous dexmedetomidine on sensory regression, duration of motor block, hemodynamic profile, level of sedation and postoperative analgesia.
Methodology: 60 patients of ASA grade I and II were enrolled in this study after getting informed consent and institutional ethical board clearance and randomly allocated into two groups. Group D received intrathecal 0.5% Heavy Bupivacaine, followed by infusion of intravenous dexmedetomidine 1µg/kg bolus over 10 minutes followed by 0.5µg/kg/hr infusion, patients in group C received intrathecal 0.5% bupivacaine heavy followed by infusion of same volume of normal saline as placebo
Results: Two segment dermatomal regression was achieved at 135±23.9 in group D. The time at which first analgesic was given to the patients when VAS >3 achieved that is in group D at 135± 23.9 min whereas in Group C it was only 77.7±11.7
Keywords: Intravenous dexmedetomidine, postoperative analgesia,sensory regression, spinal block.
References
- Swain A, Nag DS, Sahu S, Samaddar DP. Adjuvants to local anesthetics: Current understanding and future trends. World J Clin Cases. 2017 Aug 16;5(8):307–23.
- Kaur M, Singh PM. Current role of dexmedetomidine in clinical anesthesia and intensive care. Anesth Essays Res. 2011;5(2):128–33.
- Shukry M, Miller JA. Update on dexmedetomidine: use in nonintubated patients requiring sedation for surgical procedures. Ther Clin Risk Manag. 2010;6:111–21.
- Effect of low‐dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block - Kanazi - 2006 - Acta Anaesthesiologica Scandinavica - Wiley Online Library [Internet]. [cited 2018 Sep 12]. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1399-6576.2006.00919.x
- Kubre J, Sethi A, Mahobia M, Bindal D, Narang N, Saxena A. Single dose intravenous dexmedetomidine prolongs spinal anesthesia with hyperbaric bupivacaine. Anesth Essays Res. 2016;10(2):273–7.
- Kim J, Kim WO, Kim H-B, Kil HK. Adequate sedation with single-dose dexmedetomidine in patients undergoing transurethral resection of the prostate with spinal anaesthesia: a dose–response study by age group. BMC Anesthesiol. 2015 Jan 27;15(1):17.
- Elcicek K, Tekin M, Kati I. The effects of intravenous dexmedetomidine on spinal hyperbaric ropivacaine anesthesia. J Anesth. 2010 Aug;24(4):544–8.
- Gertler R, Brown HC, Mitchell DH, Silvius EN. Dexmedetomidine: a novel sedative-analgesic agent. Proc Bayl Univ Med Cent. 2001 Jan;14(1):13–21.
- Hayashi Y, Sumikawa K, Maze M, Yamatodani A, Kamibayashi T, Kuro M, et al. Dexmedetomidine prevents epinephrine-induced arrhythmias through stimulation of central alpha 2 adrenoceptors in halothane-anesthetized dogs. Anesthesiology. 1991 Jul;75(1):113–7.
- Ebert TJ, Hall JE, Barney JA, Uhrich TD, Colinco MD. The Effects of Increasing Plasma Concentrations of Dexmedetomidine in Humans. Anesthesiol J Am Soc Anesthesiol. 2000 Aug 1;93(2):382–94.
- Ustün Y, Gündüz M, Erdoğan O, Benlidayi ME. Dexmedetomidine versus midazolam in outpatient third molar surgery. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. 2006 Sep;64(9):1353–8.
- 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 Sep;71(3):447–9.
- Grewal A. Dexmedetomidine: New avenues. J Anaesthesiol Clin Pharmacol. 2011;27(3):297–302
Corresponding Author
Dr Hari Krishnan .S
Associate Professor
Add: TC 11/1759 (3) Krishnakripa, Charachira Road, Nanthancode, Kowdiar P.O
Thiruvananthapuram, Kerala, India Pin code: 695003
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DOI: https://dx.doi.org/10.18535/jmscr/v6i10.02
