Abstract

Background: Spinal anaesthesia is the preferred technique for lower limb surgeries due to its early onset of action, superior level of blockade and with a reduction of failure rate. Intrathecal α2-agonists, dexmedetomidine used as an adjuvant drug to local anaesthetics potentiate the effect of local anaesthetics and allow decrease in the required doses. In the present study, we evaluated the efficacy of intrathecal 0.5% heavy bupivacaine alone with Dexmedetomidine as an adjuvant to intrathecal 0.5% heavy bupivacaine for elective lower limb orthopaedic surgeries.

Material and Methods: A total of 60 patients were involved in prospective, randomised, observational study in department of anaesthesiology, who are scheduled for elective lower limb orthopaedic surgeries at Great Eastern Medical School and hospital. Patients belonging to ASA grade I and II were included in the study. Patients were randomly allocated into 2 groups. Each group consisted of 30 patients having Group-B as Control group which received 0.5% hyperbaric bupivacaine 3cc (15 mg) and Group-BD which received 0.5% hyperbaric bupivacaine 3cc (15mg) +10µg Dexmedetomidine.

Results: In the present study we found that in Dexmedetomidine group time to reach T10 sensory blockade, complete motor blockade was earlier, duration of motor blockade and duration of analgesia was significantly prolonged in comparison to the control group. Hemodynamic parameters were observed both intra-operatively and postoperatively. However there were a few patients who developed hypotension and Bradycardia who were easily managed without any untoward effect.

Conclusion: It can be concluded that intrathecal low dose Dexmedetomidine in the dose of 10µg along with 3 cc 0.5% hyperbaric bupivacaine, lead to an earlier onset and prolonged duration of sensory and motor blockade, excellent postoperative analgesia, with minimal adverse effects and stable hemodynamic conditions.

Keywords: Spinal anaesthesia, Dexmedetomidine, hyperbaric 0.5% Bupivacaine.