Hari Kishore1, Paul O. Raphael2, Binu Puthur Simon3, Thomas T. Vellapally4
INTRODUCTION: Various adjuvants have been used with local anesthetics in spinal anesthesia to improve the quality of block and to provide prolonged postoperative analgesia. Dexmedetomidine, the new highly selective α2-agonist drug, is now being used as a neuraxial adjuvant.
AIM: The aim of this study was to evaluate the onset and duration of sensory and motor block, hemodynamic effect, postoperative analgesia, and adverse effects of dexmedetomidine or fentanyl given intrathecally with hyperbaric 0.5% bupivacaine.
METHODOLOGY: Fifty patients classified in American Society of Anesthesiologists classes I and II scheduled for lower abdominal surgeries were included in this prospective cohort study at Amala Institute of Medical Sciences. Patients received either 15 mg hyperbaric bupivacaine plus 25 μg fentanyl (group 1, n = 25) or 15 mg hyperbaric bupivacaine plus 5 μg dexmedetomidine (group 2, n = 25) intrathecally.
RESULTS: Patients in dexmedetomidine group (2) had a significantly longer duration of motor and sensory block than patients in fentanyl group. (1) The mean time regression of motor block to reach Bromage 0 was 176.2±5.71 min in dexmeditomidine group and 166.36±5.97 min in fentanyl group (P<0.05). Duration of analgesia was 239.52±9.05 min in Dexmeditomidine group and 189.96±5.35 min in fentanyl group (p<0.05). A significant decrease in heart rate was noted in dexmedetomidine group.
CONCLUSION: Intrathecal dexmedetomidine is associated with prolonged duration of analgesia and motor block along with significant decrease in heart rate.
