Efficacy of 5 µg and 10 µg Dexmedetomidine as Adjuvants to 3 mL 0.5% Hyperbaric Bupivacaine in Pelvic and Lower Limb Orthopaedic Surgeries: A Randomised Clinical Study
Introduction: Low-dose bupivacaine used in spinal anaesthesia results in speedy recovery. For lower limb orthopaedic surgeries, to provide sufficient anaesthesia and prolong postoperative analgesia in a less cumbersome way, author can add potent adjuvants like dexmedetomidine (an alpha-2 adrener...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2025-02-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/20585/75440_CE[Ra1]_F(SHU)_QC(PS_SHU)_PF1(VD_SHU_SS)_PFA(IS)_PB(VD_IS)_PN(IS).pdf |
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| Summary: | Introduction: Low-dose bupivacaine used in spinal anaesthesia
results in speedy recovery. For lower limb orthopaedic surgeries,
to provide sufficient anaesthesia and prolong postoperative
analgesia in a less cumbersome way, author can add potent
adjuvants like dexmedetomidine (an alpha-2 adrenergic receptor
agonist) in effective and safer doses intrathecally.
Aim: To compare the effects of intrathecal 5 µg dexmedetomidine
versus 10 µg dexmedetomidine as adjuvants to 3 mL of 0.5%
hyperbaric bupivacaine in pelvic and lower limb orthopaedic
surgeries.
Materials and Methods: This randomised clinical and singleblind study study was conducted at the Operation Theatre (OT)
complex of Dheeraj Hospital, SBKS, and MIRC, Sumandeep
Vidyapeeth, Vadodara, Gujarat, India in the Department of
Anaesthesia over a period of 18 months, from September
2022 to March 2024 and total of 82 patients scheduled for
lower limb and pelvic orthopaedic surgery who were to receive
spinal anaesthesia were divided into Group D1 and D2.
Group D1 (n=41) received 3 mL of bupivacaine (0.5% heavy)
with 5 µg dexmedetomidine, totaling 3.1 mL, while group D2
(n=41) received 3 mL of bupivacaine (0.5% heavy) with 10 µg
dexmedetomidine, also totaling 3.1 mL intrathecally. The onset
and duration of sensory and motor blockade, as well as the
duration of analgesia, were noted, along with the monitoring of
haemodynamic parameters and any side effects. All observed
data were analysed using statistical tests such as the unpaired
t-test and Chi-square test. A p-value <0.05 was considered
statistically significant.
Results: Demographic data were comparable in both groups
and were non significant (p-value >0.05). The onset of sensory
block was earlier in group D2 (2.01±0.12 min) than in group D1
(2.87±0.36 min) (p-value <0.05). The onset of motor block was
also earlier in group D2 (2.63±0.26 min) compared to group D1
(3.36±0.43 min). The duration of sensory block was longer in
group D2 (457.46±32.85 min) than in group D1 (318.02±32.27
min). The duration of motor block was also longer in group D2
(396.17±36.13 min) than in group D1 (257.37±25.02 min) (p-value
<0.05). The duration of analgesia and the time until the need for
the first rescue analgesia was significantly longer in group D2
(364.29±43.64 min) compared to group D1 (219.51±23.39 min).
Conclusion: Intrathecal bupivacaine with dexmedetomidine at
a dose of 10 µg results in an earlier onset and longer duration
of sensory and motor block compared to a dose of 5 µg. The
duration of postoperative analgesia was longer, and the time
until the need for the first rescue analgesia was extended with
the 10 µg dosage. No significant side effects were observed in
either group. |
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| ISSN: | 2249-782X 0973-709X |