Title: Haemodynamic changes with lower dose of Hyperbaric Bupivacaine with Dexmeditomedine and Conventional dose of Hyperbaric Bupivacaine for Subarachnoid Block in Lower Limb Surgeries (Orthopaedic Cases)
Authors: Dr Ajith Kumar G, Dr Geethakumari. P, Dr R.S. Ushadevi
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.113
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 and haemodynamic changes.
aim of the study: Primary aim: To measure the haemodynamic changes like blood pressure and pulse rateby adding dexmeditomedine to lower dose Hyperbaric bupivacaineand Hyperbaric bupivacaine alone. Secondary aim: Compare the side effects like nausea, vomiting, 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 that Haemodynamic changes like blood pressure and pulse rate is more on the bupivacaine group than dexmeditomedine group.
Conclusion: 5 µg Dexmeditomedineto 2cc of hyperbaric Bupivacaine 0.5% is associated with lessor incidence of Hypotension and less Bradycardia compare to bupivacaine group had more incidence of hypotension and bradycardia.
Keywords: Dexmeditomedine, Hyperbaric Bupivacaine, Spinal anaesthesia.
