Background and Aims: Dexmedetomidine is increasingly being used in regional anaesthesia as an adjuvant but there is no consensus on the optimum dose when used intrathecally. The study was conducted to elucidate the dose-response relation between 3 different doses (2.5, 5, and 10 mcg) of Intrathecal dexmedetomidine as an adjuvant to hyperbaric 0.5% bupivacaine in patients undergoing elective lower abdominal and lower limb surgeries.
Settings and Design: Prospective Randomized Double-Blinded Controlled Study
Methodology: 90 Patients (18-60 years) were randomized into 3 groups of 30 patients each to receive Intrathecal bupivacaine 12.5 mg (2.5 ml) with 2.5 mcg (group A), 5ug (group B), 10ug (group C) dexmedetomidine respectively. Duration of the spinal sensory blockade (primary outcome), the onset of the blockade, time to rescue analgesia, level of sedation, duration of motor blockade, comparison of hemodynamic variables, and complications, if any were assessed.
Results: There was a significant dose-dependent prolongation of sensory block (Group A-250.67±51.39, Group B- 286±52.76, Group C- 351.00±47.00), motor block (Group A -255.53 ±44.25, Group B - 312±29.64, Group C - 361.4±16.14), time to two-segment regression (132.33±48.29, 148.77±48.89, 171.57±25.46) and time for rescue analgesia (351.33±101.19, 472.00±24.41, 738.00±67.79) with significantly low VAS in group C (p0.05) without any appreciable side effects.
Conclusion: Spinal dexmedetomidine increases the sensory, motor block duration and time to first analgesic use, and decreases analgesic consumption in a dose-dependent manner.
Key words: Dexmedetomidine, Intrathecal Dexmedetomidine, Post-operative analgesia, Adjuvant
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