Comparative study of different doses of dexmedetomidine as an adjuvant to intrathecal hyperbaric bupivacaine in lower limb orthopedic surgeries

Abstract

Background and Aim: Spinal anesthesia is most preferred anesthesia for lower limb orthopedic procedures. The present study was designed to compare the effect of two different doses of dexmedetomidine to hyperbaric bupivacaine in spinal anesthesia for lower limb orthopedic surgeries to find out the suitable dose of dexmedetomidine.
Material and Methods: Seventy five patients of ASA I & II status were randomly divided into three groups of 25 patients each. The study drug was diluted to 0.5 ml of normal saline along with 2.5 ml hyperbaric bupivacaine. Group A received 5 μg dexmedetomidine, Group B received 10 μg dexmedetomidine and Group C (control group) patients received only 0.5 ml of normal saline along with 2.5 ml hyperbaric bupivacaine. Time for onset of analgesia (pin prick method), time to achieve T10 sensory level, onset of motor block, duration of analgesia and duration of motor block and frequency of any complications were noted.
Results: Time for onset of analgesia in Group C was 3.18 ± 0.30 min but in Group A was 2.33 ± 0.14 min and in Group B was 2.24 ± 0.06 min. Duration of motor block was significantly higher in study group; 279.36 ± 14.54 min and 344.21 ± 9.19 min in Group A and B respectively, whereas it was 169.39 ± 6.96 min in control group. Duration of analgesia was also significantly higher in study Group A (342.62 ± 13.06 min) and in Group B (398.24 ± 12.31 min) compared to control group which was 204.95 ± 8.54 min.
Conclusion: 10 μg dexmedetomidine is preferred adjuvant to hyperbaric bupivacaine in spinal anesthesia with early onset of analgesia and motor block, longer duration of motor and sensory block with hemodynamic stability and minimum side effects.
Citation: Halvadia S, Patel D. Comparative study of different doses of dexmedetomidine as an adjuvant to intrathecal hyperbaric bupivacaine in lower limb orthopedic surgeries. Anaesth. pain & intensive care 2019;23(2):198-203