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Category: Volume 07 Issue 09 September 2019
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Title: Comparison of Intrathecal 0.75% Isobaric Ropivacaine and 0.75% Isobaric Ropivacaine with Dexmedetomidine, for below Umbilical Surgeries in Adults

Authors: Dr Vani. K. Venu, Dr Anzer Shah. M, Dr Santhosh Surendran

 DOI: https://dx.doi.org/10.18535/jmscr/v7i9.45

Abstract

    

Background and Objectives: Ropivacaine has reduced risk of cardiotoxicity, neurotoxicity with rapid recovery of motor function. We have conducted an observational study on effect of intrathecal 0.75% isobaric ropivacaine and combination of 0.75% isobaric ropivacaine with dexmedetomidine in spinal anesthesia for below umbilical surgeries, based on duration of analgesia, duration of motor blockade, hemodynamic profile and side effects.

Methods: After ethical committee approval and informed consent from patients, a prospective observational study was performed on 34 patients scheduled for below umbilical surgeries under subarachnoid block (SAB). This study was done among two group of patients belonging to ASA 1 and 2. Both the groups of patients were comparable with respect to sex, height and weight. Patients were divided into 2 groups according to the drugs they received, Group R: Received 2.5ml volume of 0.75% isobaric ropivacaine and 0.5ml normal saline(n=17). Group D: Received 2.5ml volume of 0.75% isobaric ropivacaine and 5µg dexmedetomidine in 0.5ml normal saline (n=17). Computer software SPSS version‑22 (IBM SPSS Statistics, Somers NY, USA) was used for statistical analysis. Independent t test and chi‑square test were used and p <0.05 was considered as significant. 

Results and Discussion: The mean onset of Analgesia in Group R was 2.8 ± 1.0 min and in Group D was 6.6 ± 3.4 min (P <0.001).Mean Duration of Analgesia in Group R was 201.6 ± 16.0 min and in Group D was 263.6 ± 12.7 min12.7 min (P <0.001). Mean Onset of motor block in Group R was 9.2 ± 2.5 min and in Group D was 11.8 ± 4.4 min (P = 0.05).Mean Duration of motor block in Group R was 104 ± 12.1 min and in Group D was 182.9 ± 18.4 min (P <0.001). Incidence of hypotension (P = 0.037 < 0.05) were more in patients who received dexmedetomidine

Conclusion: Intrathecal administration of dexmedetomidine with ropivacaine prolongs duration of analgesia and duration of motor blockade and associated with increased incidence of hypotension.

Keywords: ropivacaine. dexmedetomidine. isobaric.

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Corresponding Author

Dr Anzer Shah. M

Assistant Professor, Dept. of Anaesthesiology, Govt. TD Medical College, Alappuzha, India