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Randomized Controlled Trial
. 2018 Jun 23;18(1):74.
doi: 10.1186/s12871-018-0528-2.

The effect of intrathecal dexmedetomidine on the dose requirement of hyperbaric bupivacaine in spinal anaesthesia for caesarean section: a prospective, double-blinded, randomized study

Feng Xia  1 , Xiangyang Chang  1 , Yinfa Zhang  1 , Lizhong Wang  2 , Fei Xiao  3
Affiliations
Randomized Controlled Trial

The effect of intrathecal dexmedetomidine on the dose requirement of hyperbaric bupivacaine in spinal anaesthesia for caesarean section: a prospective, double-blinded, randomized study

Feng Xia et al. BMC Anesthesiol. .

Abstract

Background: Studies have shown that dexmedetomidine (Dex) can prolong the duration of analgesia when added to local anaesthetic as an adjuvant in a central or peripheral nerve block. We hypothesized that intrathecal Dex can reduce the ED95 of spinal hyperbaric bupivacaine. Therefore, we conducted this prospective, double-blinded, randomized study to verify our hypothesis.

Methods: Ninety patients were allocated into the Dexmedetomidine group (received bupivacaine + 5 mcg dexmedetomidine) and the Control group (received bupivacaine + the same volume of saline) using a double-blinded and randomized method. The first patient in each group received 5 mg of IT hyperbaric bupivacaine, and the next dose for the following patient was determined by the probability of successful anaesthesia of the previous neighbouring dose. An improved up-down sequence allocated method combined with probit analysis was used to determine the ED95 of intrathecal hyperbaric bupivacaine for the two groups.

Results: The ED95 and 95% confidence intervals (95% CI) of IT hyperbaric bupivacaine of the Dex group and Control group were 8.4 mg (95% CI, 6.5~ 13.8 mg) and 12.1 mg (95% CI, 8.3~ 312.8 mg), respectively. The duration of sensory block was longer in the Dex group than in the Control group (110.3 ± 35.3 vs 67.5 ± 26.2). The duration of analgesia was also longer in the Dex group than in the Control group (224.9 ± 45.4 vs 155.1 ± 31.6). The consumption of postoperative rescued sufentanil was significantly higher in the Control group than in the Dex group.

Conclusion: Intrathecal 5 mcg dexmedetomidine potentiated hyperbaric bupivacaine antinociception by 31% in spinal anaesthesia for patients undergoing caesarean section.

Trial registration: We registered this study in a Chinese Clinical Trial Registry (ChiCTR) centre on Nov 1st 2016 and received the registration number: ChiCTR-IPR-16009699 .

Keywords: Bupivacaine; Caesarean section; Dexmedetomidine; Dose-response; Intrathecal.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Institutional Ethics Committee of Jiaxing University Affiliated Women and Children Hospital (Batch No.: 201600328; 10th, Oct, 2016), and written informed consent was obtained from all patients.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Consort
Fig. 2
Fig. 2
Individual response and dose of intrathecal hyperbaric bupivacaine
Fig. 3
Fig. 3
Dose-response curve of intrathecal hyperbaric bupivacaine in the two groups
Fig. 4
Fig. 4
Duration of spinal anaesthesia
See this image and copyright information in PMC

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