Comparative study of two doses of intrathecal dexmedetomidine as adjuvant with low dose hyperbaric bupivacaine in ambulatory perianal surgeries: A prospective randomised controlled study
- PMID: 26644612
- PMCID: PMC4645353
- DOI: 10.4103/0019-5049.167485
Comparative study of two doses of intrathecal dexmedetomidine as adjuvant with low dose hyperbaric bupivacaine in ambulatory perianal surgeries: A prospective randomised controlled study
Abstract
Background and aims: Dexmedetomidine (DMT), as intrathecal adjuvant has been shown to successfully prolong duration of analgesia but delay the motor recovery. Hence, this study was designed to find out the dose of DMT which can provide satisfactory analgesia without prolonging motor block.
Methods: A total of 50 patients scheduled for elective perianal surgeries were randomly allocated to Groups C or D (n = 25). Group D received hyperbaric bupivacaine 0.5% 4 mg + DMT 5 μg and Group C received hyperbaric bupivacaine 0.5% 4 mg + DMT 3 μg intrathecally. Onset and duration of sensory and motor blockade, duration of analgesia, time for ambulation and first urination were recorded. Adverse effects if any were noted.
Results: Demographic characters, duration of surgery were comparable. The onset of sensory block to S1 was 9.61 ± 5.53 min in Group C compared to 7.69 ± 4.80 min in Group D (P = 0.35). Duration of sensory (145.28 ± 83.17 min - C, 167.85 ± 93.75 min - D, P = 0.5) and motor block (170.53 ± 73.44 min - C, 196.14 ± 84.28 min, P = 0.39) were comparable. Duration of analgesia (337.86 ± 105.11 min - C, 340.78 ± 101.81 min - D, P = 0.9) and time for ambulation (252.46 ± 93.72 min - C, 253.64 ± 88.04 min - D, P = 0.97) were also comparable. One patient in each group had urinary retention requiring catheterization. No other side effects were observed.
Conclusion: Intrathecal DMT 3 μg dose does not produce faster ambulation compared to intrathecal DMT 5 μg though it produces comparable duration of analgesia for perianal surgeries.
Keywords: Ambulatory; dexmedetomidine; intrathecal; motor block; perianal surgeries.
Figures
Similar articles
-
Dexmedetomidine as Adjuvant to Lower Doses of Intrathecal Bupivacaine for Lower Limb Orthopedic Surgeries.Anesth Essays Res. 2017 Jul-Sep;11(3):681-685. doi: 10.4103/aer.AER_243_16. Anesth Essays Res. 2017. PMID: 28928571 Free PMC article.
-
Intrathecal dexmedetomidine as adjuvant for spinal anaesthesia for perianal ambulatory surgeries: A randomised double-blind controlled study.Indian J Anaesth. 2015 Mar;59(3):177-81. doi: 10.4103/0019-5049.153040. Indian J Anaesth. 2015. PMID: 25838590 Free PMC article.
-
A comparative study of intrathecal clonidine and dexmedetomidine on characteristics of bupivacaine spinal block for lower limb surgeries.Anesth Essays Res. 2015 May-Aug;9(2):195-207. doi: 10.4103/0259-1162.153763. Anesth Essays Res. 2015. PMID: 26417127 Free PMC article.
-
Comparative study of intrathecal dexmedetomidine with intrathecal magnesium sulfate used as adjuvants to bupivacaine.J Anaesthesiol Clin Pharmacol. 2011 Oct;27(4):495-9. doi: 10.4103/0970-9185.86594. J Anaesthesiol Clin Pharmacol. 2011. PMID: 22096283 Free PMC article.
-
A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to Bupivacaine.J Anaesthesiol Clin Pharmacol. 2011 Jul;27(3):339-43. doi: 10.4103/0970-9185.83678. J Anaesthesiol Clin Pharmacol. 2011. PMID: 21897504 Free PMC article.
Cited by
-
Whole-course application of dexmedetomidine as an adjuvant to spinal-epidural anesthesia for cesarean section: A randomized, controlled trial.Heliyon. 2023 Dec 10;10(1):e23534. doi: 10.1016/j.heliyon.2023.e23534. eCollection 2024 Jan 15. Heliyon. 2023. PMID: 38173522 Free PMC article.
-
[Comparison of fentanyl and dexmedetomidine as an adjuvant to bupivacaine for unilateral spinal anesthesia in lower limb surgery: a randomized trial].Braz J Anesthesiol. 2019 Jul-Aug;69(4):369-376. doi: 10.1016/j.bjan.2019.03.005. Epub 2019 Jul 27. Braz J Anesthesiol. 2019. PMID: 31362883 Free PMC article. Clinical Trial.
-
Comparative analgesic efficacy of intravenous vs intrathecal dexmedetomidine as an adjuvant to hyperbaric bupivacaine in subarachnoid block for below knee orthopaedic surgery.Indian J Anaesth. 2020 Jun;64(6):463-469. doi: 10.4103/ija.IJA_219_20. Epub 2020 Jun 1. Indian J Anaesth. 2020. PMID: 32792709 Free PMC article.
-
Dexmedetomidine as Adjuvant to Lower Doses of Intrathecal Bupivacaine for Lower Limb Orthopedic Surgeries.Anesth Essays Res. 2017 Jul-Sep;11(3):681-685. doi: 10.4103/aer.AER_243_16. Anesth Essays Res. 2017. PMID: 28928571 Free PMC article.
-
Dexmedetomidine as an Additive to Spinal Anaesthesia in Orthopaedic Patients Undergoing Lower Limb Surgeries: A Randomized Clinical Trial Comparing Two Different Doses of Dexmedetomidine.J Clin Diagn Res. 2017 Apr;11(4):UC09-UC12. doi: 10.7860/JCDR/2017/26241.9654. Epub 2017 Apr 1. J Clin Diagn Res. 2017. PMID: 28571237 Free PMC article.
References
-
- Gudaityte J, Marchertiene I, Karbonskiene A, Saladzinskas Z, Tamelis A, Toker I, et al. Low-dose spinal hyperbaric bupivacaine for adult anorectal surgery: A double-blinded, randomized, controlled study. J Clin Anesth. 2009;21:474–81. - PubMed
-
- Kim JE, Kim NY, Lee HS, Kil HK. Effects of intrathecal dexmedetomidine on low-dose bupivacaine spinal anesthesia in elderly patients undergoing transurethral prostatectomy. Biol Pharm Bull. 2013;36:959–65. - PubMed
-
- Awad IT, Cheung JJ, Al-Allaq Y, Conroy PH, McCartney CJ. Low-dose spinal bupivacaine for total knee arthroplasty facilitates recovery room discharge: A randomized controlled trial. Can J Anaesth. 2013;60:259–65. - PubMed
-
- Carr DB, Cousins MJ. Spinal route of analgesia. In: Cousins MJ, Carr DB, Horlocker TT, Bridenbaugh PO, editors. Cousins and Bridenbaugh's Neural Blockade in Clinical Anaesthesia and Pain Medicine. 4th ed. Philadelphia: Lipincott Williams and Wilkins; 2009. pp. 886–95.
-
- Eid HE, Shafie MA, Youssef H. Dose-related prolongation of hyperbaric bupivacaine spinal anesthesia by dexmedetomidine. Ain Shams J Anesthesiol. 2011;4:83–95.
LinkOut - more resources
Full Text Sources
Other Literature Sources