Abstract
Aim: The study was done to evaluate the effects of intravenous administration of dexmedetomidine and midazolam on spinal anaesthesia with 0.5% hyperbaric bupivacaine in transurethral resection of prostate (TURP).
Methods: 75 patients of ASA grade I and II posted for elective transurethral resection of prostate surgeries were included in the study and randomly allocated into three groups. All three groups received 3ml of intrathecal 0.5% bupivacaine heavy, followed by infusion of study drug. Group D received intravenous dexmedetomidine 0.5mcg/kg over 10 min, Group M received infusion of Midazolam and Group NS received infusion of same volume of normal saline as placebo. Duration of analgesia, time to 1st analgesia request, VAS score, hemodynamics and side effects were recorded and analyzed.
Results: The prolongation in duration of analgesia in dexmedetomidine group was statistically significant in comparison to other groups. Time to 1st analgesia request was delayed in group D compared to other groups which was statistically significant. hemodynamic stability was well maintained in dexmedetomidine group.
Conclusion: Intravenous dexmedetomidine is not only prolong the duration of spinal analgesia but also maintain hemodynamic stability in TURP surgery.
Keywords: dexmedetomidine, spinal anaesthesia, hyperbaric bupivacaine, TURP.
References
- Memi D, Turan A, Karamanlioğlu B, Pamukçu Z, Kurt I. Adding dexmedetomidine to lidocaine for intravenous regional anesthesia. Anesth Analg. 2004;98:835–40.
- Reddy VS, Shaik NA, Donthu B, Reddy Sannala VK, Jangam V. Intravenous dexmedetomidine versus clonidine for prolongation of bupivacaine spinal anesthesia and analgesia: A randomized double-blind study. J Anaesthesiol Clin Pharmacol. 2013;29:34.
- Gerlach AT, Dasta JF. Dexmedetomidine: An updated review. Ann Pharmacother. 2007; 41:245–52.
- Harsoor S, Rani DD, Yalamuru B, Sudheesh K, Nethra S. Effect of supplementation of low dose intravenous dexmedetomidine on characteristics of spinal anaesthesia with hyperbaric bupivacaine. Indian J Anaesth. 2013;57:265–9.
- Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions. Anesth Analg. 2000;90:699–705.
- Kaya FN, Yavascaoglu B, Turker G, Yildirim A, Gurbet A, Mogol EB, et al. Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia. Can J Anaesth. 2010;57:39–45.
- Joana A, Flávio R. Dexmedetomidine: current role in anaesthesia and intensive care. Rev Bras Anestesiol. 2012;62(1):125–33.
- Al-Mustafa MM, Abu-Halaweh SA, Aloweidi AS, Murshidi MM, Ammari BA, Awwad ZM, et al. Effect of dexmedetomidine added to spinal bupivacaine for urological procedures. Saudi Med J. 2009;30(3):365–70.
- Shukla D, Verma A, Agarwal A, et al. Comparative study of intrathecal dexmedetomidine with intrathecal magnesium sulfate used as adjuvants to bupivacaine. Journal of Anaesthesiology, Clinical Pharmacology. 2011;27(4):495–99.
- Abdelhamid SA, El-lakany MH. Intrathecal dexmedetomidine: Useful or not? J Anaesth Clin Res. 2013;4:351..
- Hala E A Eid, Shafie M, Youssef H. Dose related prolongation of hyperbaric bupivacaine spinal anaesthesia by Dexmedetomidine. Ain Shams Journal of Anaesthesiology. 2011;4(2):83–95.
- Kanazi GE, Aouad MT, Jabbour-Khoury SI, et al. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Acta Anaesthesio-logica Scandinavica. 2006;50:222–27.
- Gupta R, Verma R, Bogra J, et al. A comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to bupivacaine. J Anaesthesiol Clin Pharmacol. 2011;27:339–43.
- Gupta K, Tiwari V, Gupta PK, Pandey MN, Agarwal S, Arora A. Prolongation of subarachnoid block by intravenous dexmedetomidine for sub umbilical surgical procedures: A prospective control study. Anesth Essays Res. 2014;8(2):175-8.
Corresponding Author
Dr Debasish Swain
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