Sudhakar B 1 , Sivaram Amudala 2 , Bhavya Gatte 3 , Devika Bangaru 4 , Subramanyam Koti
BACKGROUND Dexmedetomidine, a highly selective α2-adrenoceptors agonist has recently been introduced in anaesthesia practice. It is currently being used for continuous intravenous sedation in the intensive care setting and procedural sedation in nonintubated patients. Its benefits as an adjuvant to local anaesthetics in peripheral nerve blocks. Dexmedetomidine by virtue of its sedative, analgesic, anxiolytic, sympatholytic, anaesthetic-sparing and haemodynamic stabilising properties have been used as an adjunct to local anaesthetics for prolongation of effect. MATERIALS AND METHODS This study was conducted on 60 patients undergoing various lower abdominal and lower limb surgeries under subarachnoid block in two groups. Group “IT”- (n=30) intrathecal dexmedetomidine - 16 mcg with 0.5% bupivacaine, total of 3.2 mL. Group “IV” - (n=30) intrathecal 0.5% bupivacaine 3.2 mL followed by intravenous infusion of dexmedetomidine 1 mcg/kg given over 10 mins. followed by maintenance dose of 0.25 mcg/kg/hr. of infusion of dexmedetomidine. RESULTS The mean time for onset of sensory block was 2.6 minutes for group IT and 3.22 minutes for Group IV with p value of 0.03, which is clinically and statistically significant. The mean time for onset of motor block was 4 minutes for group IT and 5 minutes for Group IV with p value of 0.01, which is clinically and statistically significant. CONCLUSION Intrathecal dexmedetomidine with bupivacaine provides better haemodynamic stability, faster onset of sensory and motor blockade, provides longer duration of sensory and motor blockade and also adequate postoperative analgesia compared with intravenous infusion of dexmedetomidine in spinal anaesthesia with bupivacaine.
