763 ROLE OF MIDAZOLAM ADDED TO LOW DOSE HYPERBARIC BUPIVACAINE IN SUB-ARACHNOID BLOCK FOR LOWER UTERINE CAESAREAN SECTION - A COMPARATIVE STUDY

Background: Spinal anaesthesia induced hypotension, a common problem during caesarean section, is associated with maternal nausea and vomiting and the risk of neonatal acidosis. Low dose local anaesthetic combined with opioids spinal anaesthesia better preserves maternal haemodynamic stability, resulting in equally efficacious anaesthesia.Objectives: To investigate whether this synergistic action could be used to provide effective anaesthesia while preventing hypotension during caesarean operation.Materials and method: This prospective study included 60 pregnant mothers scheduled for caesarean operation who were then divided into two groups (thirty in each). Group-A received a spinal injection of 12.5 mg of standardized 0.5% hyperbaric bupivacaine and group-B received 8 mg of 0.5% hyperbaric bupivacaine with 20 ?gm fentanyl. Hypotension was defined as the systolic blood pressure drops below 90 mm of Hg or a decrease of systolic blood pressure 25% from pre anaesthesia level and hypotension was treated with a bolus of 5 to 10 mg of intravenous ephedrine. The quality of anaesthesia and postoperative analgesia were evaluated.Results: The mean time required to reach peak sensory level was earlier in group-B than group-A and was statistically significant (p<0.05). The decrease in systolic blood pressure in group-A was significantly more than group-B (p<0.05) and vasopressor requirement was also significantly more in group-A compared to group-B (p<0.05). Mean time of two segment regression of sensory analgesia and complete sensory recovery was significantly early in group-B (p<0.05). Duration of motor recovery in group-B was significantly earlier (p<0.05). The duration of effective analgesia was significantly more in group-B (p<0.05).Conclusion: Low dose Bupivacaine with fentanyl provided excellent intraoperative sensory and motor blockade, haemodynamic stability, and effective postoperative analgesia for caesarean delivery.Delta Med Col J. Jan 2016 4(1): 24-30

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USE OF DEXMEDETOMIDINE AS AN ADJUVANT TO 0.5% HYPERBARIC BUPIVACAINE IN SUBARACHNOID BLOCK

10.36106/ijsr/5100889 ◽

2019 ◽

pp. 1-3

Author(s):

Dhananjay Yadav

Keyword(s):

Comparative Study ◽

Spinal Anaesthesia ◽

Low Dose ◽

Intrathecal Morphine ◽

Controlled Study ◽

Double Blind Study ◽

Hyperbaric Bupivacaine ◽

Double Blind ◽

Lower Limb Surgery ◽

Wonder Drug

[1] Kanazi GE, Aouad Mt, KJabbour-Khoury SI et al: Effect of low dose dexmedetomidine or clonidine on the characteristics of spinal bupivacaine block. Act a Anaesthesiol Scand 2006;50:222-7 [2] Hala EEA, Mohamed SA, Hend Y. Dose related prolongation of hyperbaric bupivacaine spinal anaesthesia by dexmedetomidine. Ain Shams J Anaesthesiology 2011;4:83-95 [3] Kim JE, Kim NY, Lee HS, Kil HK. Effects of intrathecal dexmedetomidine on low dose bupivacaine spinal anaesthesia in elderly patients undergoing transurethral prostectomy. Bio Pharm Bul 2013;36;959-965. [4] Mahendru V, Tewari A, Katyal S et al. A Comparison of intrathecal dexmedetomidine, clonidine, & fentanyl as adjuvants to hyperbaric bupivacaine for lower limb surgery: A double blind controlled study. J Anaesthesiol Clin Phrmacol 2013;29:496-502 [5] Soumya samal et al: Intrathecal buterphenol or intrathecal dexmedetomidine for post operative analgesia a comparative study: healt agenda, vol 2. Issue 1. Jan 2014 [6] Dexmedetomidine in anaesthesia practice: a wonder drug? IJAaug 2014 by S K Harsoor [7] Sudheesh K, Raghvendra Rao R S, Kavya M, Aarthi J, Rani D D, Nethra S S. Comprative study of 2 doses of intrathecal dexmedetomidine as adjunct with low dose hyperbaric bupivacaine in ambulatory perianal surgeries. A prospective randomized controlled study. Indian J Anaesth 2015;59:648-52 [8] El-Attar A, Aleen MA, Beltagy R, Ahmed W. A comparative study of intrathecal dexmedetomidine and fentanyl as additives to bupivacaine. Res Opin Anesth Intensive care 2015;1:43-9 [9] Kurhekar P, Kumar SM, Sampath D. Comparative evaluation of intrathecal morphine and intrathecal dexmedetomidine in patients undergoing gynecological surgeries under spinal anaesthesia. A prospective randomized double blind study. Indian J anaestg 2016;60:382-7

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COMPARATIVE STUDY USING LOW-DOSE KETAMINE OR ONDANSETRON FOR PREVENTION OF POSTOPERATIVE SHIVERING IN PATIENTS UNDERGOING ELECTIVE CAESAREAN SECTION UNDER SPINAL ANAESTHESIA

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2017/867 ◽

2017 ◽

Vol 4 (73) ◽

pp. 4355-4358

Author(s):

Manjunath Timmappa Bhat ◽

Bharath Kumar Hegde

Keyword(s):

Caesarean Section ◽

Comparative Study ◽

Spinal Anaesthesia ◽

Low Dose ◽

Elective Caesarean Section

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A Comparative Study To Evaluate The Role Of Inhaled Steroid Versus Low Dose oral Steroid In Patients Of COPD

International Journal of Basic & Clinical Pharmacology ◽

10.5455/2319-2003.ijbcp20150408 ◽

2015 ◽

pp. 1

Author(s):

Arpita Singh ◽

Surya Kant ◽

Ajay Verma ◽

Ankit Bhatia ◽

Mohd Siddiqui ◽

...

Keyword(s):

Comparative Study ◽

Low Dose ◽

Oral Steroid ◽

Dose Oral

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Low Dose Hyperbaric Bupivacaine and Dexmedetomidine as an Adjuvant in Spinal Anaesthesia, Caesarean Section: A Randomized Controlled Trial

10.21203/rs.3.rs-33452/v1 ◽

2020 ◽

Author(s):

Ahmed Ashraf Nasr ◽

Safaa Mohamed Helal ◽

Wesam Eldin Abdelrahman Soltan

Keyword(s):

Caesarean Section ◽

Postoperative Analgesia ◽

Ordinal Data ◽

Low Dose ◽

Enhanced Recovery ◽

Elective Caesarean Section ◽

T Test ◽

Control Group ◽

P Value ◽

Hyperbaric Bupivacaine

Abstract Background Alpha-2 agonist, e.g. dexmedetomidine, is a non-opioid adjuvant with a substantial role in extending the analgesic duration of the subarachnoid block. Here, we aim to test the efficacy of adding dexmedetomidine to hyperbaric bupivacaine in the caesarean delivery, targeting enhanced postoperative analgesia and more stable hemodynamics. Methods 40 parturient women scheduled for elective caesarean section were enrolled and randomly allocated to two groups. Low Dose – Dexmedetomidine (LD- DEX) group (n = 20) received 7 mg hyperbaric bupivacaine plus 10 µg dexmedetomidine, control group (n = 20) received 12 mg hyperbaric bupivacaine. Continuous normally distributed data were expressed as mean and standard deviation. Ordinal data and continuous data not fitting to the normal distribution curve were presented as medians (range) meanwhile categorical data were reported as percentage of the total number. Regarding the autonomic variables, we did a stratified analysis to compare the mean change of these variables every 3 minutes till 60 minutes through a two-sample t-test (Welch t-test). All statistical analyses were performed using R software version 3.4.4 Results LD- DEX groups showed significant faster and prolonged sensory block (P-value < 0.05), stable maternal hemodynamic maintained by less amount of IV fluids (P-value < 0.01), lower doses of ephedrine (P-value = 0.02), no signs of foetal distress, and low incidence of postoperative maternal shivering. As well, 3 hours cut off pain was more significant in LD- DEX group (P-value < 0.01). Conclusion LD- DEX group provided an optimum intraoperative condition and postoperative analgesia with less maternal side effects and no neonatal risks, encouraging enhanced recovery and less hospital in-stay.

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