Extent of Hyperbaric Spinal Anesthesia Influences the Duration of Spinal Block

2000 ◽  
Vol 92 (5) ◽  
pp. 1319-1323 ◽  
Author(s):  
Nicoline E. Kooger Infante ◽  
Elizabeth Van Gessel ◽  
Alain Forster ◽  
Zdravko Gamulin
Keyword(s):  
Spinal Anesthesia ◽  
Spinal Block ◽  
Sensory Level ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Operative Site ◽  
Lower Limb Surgery ◽  
American Society ◽  
American Society Of Anesthesiologists

Background The influence of spread of spinal anesthesia on the duration of spinal blockade has been suggested but never investigated specifically. Because elimination of local anesthetic from subarachnoid space is probably dependent of the surface available for its diffusion and vascular absorption, the current study was designed to evaluate the hypothesis that with a same dose of hyperbaric bupivacaine, a higher anesthetic level would result in a shorter duration of spinal blockade than a lower level. Methods Three milliliters (15 mg) of hyperbaric bupivacaine, 0.5%, was injected intrathecally in 40 patients classified as American Society of Anesthesiologists physical status I or H scheduled for lower limb surgery during spinal anesthesia. To obtain significantly different anesthetic levels, the patients were positioned randomly either horizontally or with the torso elevated 30. Regression of sensory level and motor blockade, the appearance of pain at the operative site, and hemodynamic changes were evaluated. Results The maximum cephalad spread of sensory blockade (expressed as the median with ranges in parentheses) was significantly higher in the horizontal group than in the group with 30-degree elevation of the torso, i.e., T3.5 (T1-T9) versus T10 (T6-L1), with respectively significantly faster regression times (mean ¿ SD) by two segments (216 ¿ 46 mm vs. 253 ¿ 64 mm) and to segment L4 (269 ¿ 53 mm i s. 337 ¿ 58 mm), as well as shorter time to complete motor blockade recovery (173 ¿ 34 mm i s. 233 ¿ 58 mm) and faster appearance of pain at the operative site (221 ¿ 68 mm vs. 271 ¿ 56 mm). Conclusion The results indicate that with the same dose of hyperbaric bupivacaine, the duration of spinal blockade is longer in patients with restricted spread.

Intravenous Dexmedetomidine enhances the Duration of Spinal Anesthesia with 0.5% Hyperbaric Bupivacaine in Lower Abdominal Surgeries

2017 ◽  
Vol 2 (3) ◽  
pp. 144-148
Author(s):  
Malti Agrawal ◽  
Yogesh K Sharma
Keyword(s):  
Spinal Anesthesia ◽  
Diclofenac Sodium ◽  
Group Iv ◽  
Control Group ◽  
Spinal Block ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Group Iii ◽  
American Society ◽  
American Society Of Anesthesiologists

ABSTRACT Introduction Spinal block is a preferred technique for most lower abdominal and lower limb surgeries. Lignocaine had been the local anesthetic of choice for decades in such surgeries. With the advent of adjuvants, now it has become possible to enhance the duration of spinal anesthesia. These adjuvants can be given intravenously or intrathecally. Intravenous clonidine and dexmedetomidine have been used in recent studies as adjuvant in spinal anesthesia with promising results. Dexmedetomidine is a more suitable adjuvant compared with clonidine due to its more selective alpha-2A receptor agonist activity. Aims and objectives To evaluate the effect of intravenous dexmedetomidine on spinal anesthesia with 0.5% bupivacaine in lower abdominal surgeries in terms of onset and duration of sensory and motor blockade and sensory regression. Materials and methods Sixty patients of American Society of Anesthesiologists grades I and II, 25 to 60 years of age, posted for elective lower abdominal surgeries under spinal anesthesia were included in the study and randomly allocated into computer-generated two groups. Group IV received intrathecal 0.5% bupivacaine heavy and intravenous infusion of dexmedetomidine 1 μg/kg over 20 minutes followed by 0.5 μg/kg/hour till the end of surgery. Patients in group III (control group) received intrathecal 0.5% bupivacaine heavy and intravenous normal saline as placebo. Results In groups IV and III, mean duration of analgesia was 209 ± 29.93 and 150.20 ± 3.46 minutes respectively. This increase in duration of analgesia in dexmedetomidine group was statistically significant. The mean duration of motor blockade was 189.48 ± 1.34 and 158.18 ± 3.27 minutes respectively. Injection diclofenac sodium 75 mg intramuscularly was used as rescue analgesic. How to cite this article Sharma YK, Agrawal M. Intravenous Dexmedetomidine enhances the Duration of Spinal Anesthesia with 0.5% Hyperbaric Bupivacaine in Lower Abdominal Surgeries. Int J Adv Integ Med Sci 2017;2(3):144-148.

scholarly journals Comparison of Effect of Intrathecal Fentanyl-bupivacaine and Tramadol-bupivacaine Combination on Postoperative Analgesia in Lower Abdominal Surgeries

2016 ◽  
Vol 1 (2) ◽  
pp. 35-40 ◽  
Author(s):  
Naina P Dalvi ◽  
Narendra Patil
Keyword(s):  
Blood Pressure ◽  
Postoperative Analgesia ◽  
Total Duration ◽  
Double Blind Study ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Sensory Blockade ◽  
Prolonged Duration ◽  
American Society

ABSTRACT Introduction This single-center, prospective, randomized, double-blind study compares the effect of intrathecal fentanylbupivacaine and tramadol-bupivacaine on the onset and duration of sensory and motor blockade, as well as postoperative analgesia in lower abdominal surgeries. Materials and methods Patients of either sex, aged 18 to 60 years, American Society of Anesthesiologists (ASA) grade I/II undergoing lower abdominal surgeries like appendicectomy, inguinal hernia repair surgery, and hydrocele surgery were administered either 2.5 mL of 0.5% bupivacaine + 0.5 mL (25 μg) of fentanyl citrate (group F) or 2.5 mL of 0.5% bupivacaine + 0.5 mL (25 mg) of tramadol (group T) intrathecally. Monitoring of the vital parameters, onset and duration of sensory and motor block, duration of postoperative analgesia, visual analog scale (VAS) score, sedation score, and any adverse drug reactions was done at predetermined intervals. Results Sixty patients were randomized to the group F (n = 30) and group T (n = 30). The duration of sensory blockade was significantly prolonged in group F (314.66 ± 49.25 minutes) as compared to group T (261.66 ± 27.92 minutes). Similarly, duration of motor blockade was longer in group F (263.66 ± 40.97 minutes) compared to group T (214.66 ± 26.61 minutes). The total duration of analgesia was significantly prolonged (p < 0.001) in group F (412 ± 97.888 minutes) compared to group T (301 ± 38.75 minutes). Hemodynamic parameters, such as pulse, systolic blood pressure, diastolic blood pressure and oxygen saturation were comparable in both the groups. Visual analog scores were significantly lower in the group F patients as compared to the group T patients. The group F patients had got significantly higher sedation scores as compared to Group T patients. Discussion Fentanyl 25 μg, when added to 2.5 mL of 0.5% hyperbaric bupivacaine, confers prolonged duration of sensory and motor blockade than 25 mg tramadol added to 2.5 mL of 0.5% hyperbaric bupivacaine. The bupivacaine-fentanyl combination prolonged duration of sensory and motor blockade, improved analgesia, as manifested by lower pain scores, and prolonged duration of postoperative analgesia. How to cite this article Dalvi NP, Patil N. Comparison of Effect of Intrathecal Fentanyl-bupivacaine and Tramadol-bupivacaine Combination on Postoperative Analgesia in Lower Abdominal Surgeries. Res Inno in Anesth 2016;1(2):35-40.

scholarly journals Comparison of dexmedetomidine and buprenorphine as an adjuvant to bupivacaine during spinal anaesthesia for tibial interlocking nailing surgeries

2017 ◽  
Vol 4 (6) ◽  
pp. 1653
Author(s):  
Amitha S. ◽  
Pradeep R.
Keyword(s):  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Chi Square ◽  
Double Blind ◽  
Sensory Blockade ◽  
Exact Test ◽  
Interlocking Nailing ◽  
Group 3

Background: Buprenorphine is being used as an adjuvant to local anaesthetic for spinal anaesthesia since long. Dexmedetomidine is a new drug which has got alpha 2 agonistic property, and is being tried for spinal anesthesia along with bupivacaine in recent times. Settings and Design: This study was conducted in a prospective, randomized, controlled and double-blind manner. The study included ninety American Society of Anaesthesiologists class I and II patients undergoing tibial interlocking nailing surgeries under spinal anaesthesia.Methods: The patients were randomly divided into three groups (n=30 each) by closed envelope technique. Patients in group 1 received 15 mg of 0.5% hyperbaric bupivacaine, group 2 received 15 mg of 0.5% hyperbaric bupivacaine with 30μg of buprenorphine, and group 3 received 15 mg of 0.5% hyperbaric bupivacaine with 5μg dexmedetomidine for spinal anesthesia. The duration of motor and sensory blockade and any adverse events were recorded. Data were analysed using Chi-square test or Fisher’s exact test for categorical data and analysis of variance for continuous data. A value of P<0.05 was considered as statistically significant.Results: In our study the subjects in group 3 (dexmedetomidine) group had significantly longer period of motor blockade (240±20min) and sensory blockade (180±22.2min) compared to other groups, which is statistically significant (P=0.0001 and P= 0.006 respectively). The time to first request of analgesic in the post-operative period was also longer (240±30.2min) in dexmedetomidine group when compared with other groups (P=0.0001). There were no untoward complications (hypotension, sedation) in any groups.Conclusions: We concluded that dexmedetomidine (5μg) with bupivacaine for spinal anesthesia gives significantly longer duration of sensory and motor blockade, than buprenorphine (30μg) with bupivacaine for spinal anaesthesia.

scholarly journals Comparative Study of Ketamine and Fentanyl When Added to Intrathecal Bupivacaine on Sensory and Motor Blockade in Patients Undergoing Total Abdominal Hysterectomy

2021 ◽  
Vol 8 (8) ◽  
pp. 420-426
Author(s):  
Saba Wani ◽  
Sadia Ali Wani ◽  
Salma Mariyam
Keyword(s):  
Comparative Study ◽  
Onset Time ◽  
Control Group ◽  
Sensory Level ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Sensory Blockade ◽  
Group I ◽  
Patient Consent

Introduction:- Ketamine and Fentanyl used intrathecally as adjuvant to 0.5% hyperbaric bupivacaine for patients undergoing TAH to shorten the onset of sensory and motor blockade and prolonging the duration of block. Aims and Objective:-We evaluated onset and duration of sensory and motor blockade and timing of regression of sensory blockade to T 12 and motor blockade to Bromage scale 3. Material and Methods:-This analytical Comparative Study was conducted in Department of Anaesthesiology, Era’s Lucknow Medical College and Hospital, Era University, Lucknow over a period of eighteen months from 2016 -2018 following approval from institutional ethical committee and written informed patient consent. The sample size of 162 female patient aged 40 to 60 years, belonging to ASA physical status 1 and 2 undergoing TAH were randomly allocated to three groups in double blind manner. Group I Received Inj. Bupivacaine (0.5% Heavy) 3.0ml + Inj. Ketamine (25 mg), Group II Received Inj. Bupivacaine (0.5% Heavy) 3.0 ml + Inj. Fentanyl (25 µgm), Group III (Control Group): Received Inj. Bupivacaine (0.5% Heavy) 3.0 ml + Normal saline 0.5 ml. Onset and Duration of Sensory and Motor Blockade and time taken for regression of sensory level to T12 and motor level to Bromage scale 3 noted. Results:- The present study showed that both Ketamine as well as Fentanyl shortened the onset time and prolonged the block duration. However, with respect to onset time, ketamine has shorter onset of blockade than fentanyl. Conclusion:- Both the modalities independently assured quicker onset and prolonged duration of block, thus suggesting that adjuvant use of either of two could be beneficial. Keywords: TAH, Ketamine, Fentanyl, Bupivacaine.

scholarly journals Comparison of Effectiveness of Ropivacaine (0.5 %) with Fentanyl, and Bupivacaine (0.5 %) with Fentanyl, in Spinal Anaesthesia in Lower Limb and Lower Abdominal Surgeries

2020 ◽  
Vol 7 (48) ◽  
pp. 2836-2840
Author(s):  
Abhilasha Singh ◽  
Shivpriya P.N ◽  
Sanjeev Sharma ◽  
Alka Gupta
Keyword(s):  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Motor Blockade ◽  
Lower Abdomen ◽  
Sensory Blockade ◽  
American Society ◽  
Comparison Of Effectiveness ◽  
American Society Of Anesthesiologists ◽  
To Receive ◽  
Fentanyl Group

BACKGROUND We wanted to compare the efficacy of motor and sensory blockade in lower limb and lower abdomen surgeries achieved by ropivacaine-fentanyl and bupivacainefentanyl combinations administered intrathecally. METHODS A prospective, randomized [block randomization], interventional, comparative study was conducted on 116 American Society of Anesthesiologists physical status I – II patients. They were randomly divided into two groups of 58 patients each, to receive either 3 mL of 15 mg of 0.5 % ropivacaine with 25 mcg fentanyl [group RF] or 3 mL of 15 mg of 0.5 % bupivacaine with 25 mcg fentanyl [group BF] intrathecally. Pinprick test and Bromage scale was used to assess sensory and motor blockade, respectively. RESULTS Time taken for motor regression in group RF is lesser than that taken in group BF. CONCLUSIONS Ropivacaine along with fentanyl is more advantageous in spinal anaesthesia for infraumbilical surgeries due to brief duration of motor blockade. KEYWORDS Bupivacaine, Fentanyl, Ropivacaine, Spinal Anaesthesia

scholarly journals Comparision of dexmedetomidine and clonidine with hyperbaric bupivacain in spinal anaesthesia

2021 ◽  
Vol 8 (12) ◽  
pp. 3563
Author(s):  
Anshul Agrawal ◽  
Sunita Jain ◽  
Ashish Goyal
Keyword(s):  
Spinal Anaesthesia ◽  
Onset Time ◽  
Peak Level ◽  
Sensory Block ◽  
Double Blind Study ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Sensory Blockade ◽  
Lower Limb Surgery

Background: Alpha-2 adrenergic agonists used as adjuvant to spinal anaesthesia produce substantial sensory and motor blockade of bupivacaine. This study was planned to compare the sensory and motor blockade characteristics of intrathecal combinations of adjuvants dexmedetomidine and clonidine with hyperbaric bupivacaine in the cases who underwent lower limb surgery under spinal anaesthesia.Methods: This was prospective, randomized, double blind study. 90 patients of age group between 18-60 years, ASA grade I and II were allotted into 3 equal groups. Group B received 15 mg bupivacaine plain, group BD and BC received dexmedetomidine (5mcg) and clonidine (50mcg) as adjuvants to bupivacaine respectively.Results: The duration of 2 dermatome regression time, sensory blockade and motor blockade were longest in dexmedetomidine group (129.37±4.87; 386±58.43; 353±48.87) in compared to clonidine (109.77±5.95; 296.53±57.19; 269.7±51.2) and bupivacaine group (81.03±6.83; 211.1± 30.47;181.03±20.8). Both drugs do not affect the peak level of sensory blockade, sensory block onset and motor block onset time. Dexmedetomidine and clonidine do not cause sedation in intraoperative and postoperative period.Conclusions: We conclude that addition of dexmedetomidine and clonidine in spinal anesthesia with hyperbaric bupivacaine increase the duration of ‘2 dermatome regression’ time, sensory and motor blockade and both are more with dexmedetomidine than with clonidine.

A study of intrathecal low dose bupivacaine and fentanyl versus conventional dose of bupivacaine alone for elective caesarean section

2021 ◽  
Vol 19 (3) ◽  
pp. 86-90
Author(s):  
Rama Rao V M ◽  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Elective Caesarean Section ◽  
Sensory Block ◽  
Rapid Onset ◽  
P Value ◽  
Sensory Level ◽  
Lipid Solubility ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade

Background: Spinal anesthesia is the most common method of the regional block in cesarean section, because it is easy to perform, economical produces rapid onset of anesthesia, and good muscle relaxation, and most importantly, it gives immense pleasure to the conscious mother. To improve the quality of subarachnoid block, intrathecal opioids are used as adjuvants to Bupivacaine. Fentanyl has a rapid onset of action as a lipophilic opioid following intrathecal administration. Because of high lipid solubility, it undergoes rapid uptake by the spinal cord, and hence the chances of delayed respiratory depression are less. Methods: We randomly selected 60 patients belonging to the American Society of Anesthesiologists (ASA) class I and II, who are scheduled for elective LSCS. These patients were divided randomly into two groups of 30 each. Group B received 10mg of 0.5% hyperbaric bupivacaine (2ml). Group BF received 7.5mg of 0.5% hyperbaric bupivacaine (1.5ml) with 25mcg of Fentanyl (0.5ml). Lumbar puncture was performed at the level of L3-L4 with 23 Guage Quincke Babcock's needle with the patient in the right lateral position. The sensory block was assessed with the loss of pin prick sensation, and the motor block was set using the Bromage scale technique. We also recorded the hemodynamic parameters like pulse rate, blood pressure, oxygen saturation. Results: No significant statistical difference was found in demographic data between the two groups. Group BF showed early onset of the sensory block with a P value of 0.001. Time taken to attain peak sensory level was early in the BF group with a P value of 0.001. The total duration of sensory block and duration of effective analgesia was longer in the BF group with a P value of 0.001. The onset of motor blockade was early in the bupivacaine only group with a P value of 0.02. Conclusion: The intrathecal fentanyl 25mcg reduces the dose of 7.5 mg of 0.5% hyperbaric Bupivacaine for spinal anesthesia in cesarean section, thus reducing the incidence of side effects associated with it. By its synergistic effect with 0.5% hyperbaric bupivacaine, it provides better excellent sensory blockade and postoperative analgesia, good hemodynamic stability, less incidence of complications like Nausea, vomiting, and shivering without compromising the safety of mother and fetus in comparison to intrathecal 10mg of 0.5% hyperbaric Bupivacaine alone.

scholarly journals EFFECT OF INTRAVENOUS VERSUS INTRATHECAL DEXMEDETOMIDINE ON CHARACTERISTICS OF HYPERBARIC BUPIVACAINE SPINAL ANESTHESIA IN LOWER LIMB SURGERY

2018 ◽  
Vol 11 (7) ◽  
pp. 427
Author(s):  
Laxman K Senapati ◽  
Priyadarsini Samanta
Keyword(s):  
Side Effects ◽  
Spinal Anesthesia ◽  
Lower Limb ◽  
Motor Block ◽  
Infusion Pump ◽  
Controlled Study ◽  
Sensory Level ◽  
Hyperbaric Bupivacaine ◽  
Rescue Analgesia ◽  
Lower Limb Surgery

Objectives: Dexmedetomidine was shown to prolong the duration of spinal anesthesia and enhance post-operative analgesia. The aim of the study was to compare the effect of intravenous (IV) versus intrathecal (IT) administration of dexmedetomidine on bupivacaine spinal anesthesia in patients undergoing lower limb surgery.Methods: A prospective randomized controlled study was conducted during the year 2014–15. 60 American Society of Anesthesiologists physical status I–II aged 18–60 years scheduled for lower limb surgery under spinal anesthesia were assigned randomly to two groups: (1) IT group (IT group) (n=30) patients received 3 ml of 0.5% hyperbaric bupivacaine and 5 μg of dexmedetomidine intrathecally (100 μg/1 ml ampoule drawn in 40 IU/ml insulin syringe making 5 μg=2 IU=0.05 ml) and (2) IV group (IV group) (n=30) received 3 ml of 0.5% hyperbaric bupivacaine and 0.05 ml of normal saline intrathecally followed 5 min later by IV dexmedetomidine 0.5 μg/kg by infusion pump over 10 min as a single dose.Results: The IT group had a statistically significantly earlier sensory onset to T10 and shorter time from injection to highest sensory level (p<0.001). The regression times of two dermatomes, regression time to S1 dermatome and time to reach Bromage 3 motor block were significantly less in the IT group, whereas regression time to Bromage 0 was prolonged (p<0.001). The IT group showed a significantly longer time to the use of rescue analgesia and less analgesic consumption in first 24 h than the IV group (p<0.001). Furthermore, the intensity of pain was significantly less in the IT group as compared to IV group (p<0.001). Compared with IV group, the IT group had low sedation score, fewer overall side effects, which was statistically not significant (p>0.05).Conclusion: In bupivacaine spinal anesthesia for limb surgeries, dexmedetomidine, when administered intrathecally, has greater augmentation to sensory and motor block, more hemodynamic stability, better analgesic properties, and fewer overall side effects compared to the IV route of administration.

scholarly journals SPINAL ANESTHESIA

2016 ◽  
Vol 23 (02) ◽  
pp. 161-165
Author(s):  
Hamid Raza ◽  
Bashir Ahmed ◽  
Kamlaish Kamlaish ◽  
Saqib Basr ◽  
Ahmed Ali
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Motor Blockade ◽  
Lower Segment ◽  
Hemodynamic Changes ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Lower Segment Cesarean Section ◽  
Group A ◽  
Group B

Objective: The purpose of the study is to compare and assess the sensoryand motor block along with the associated hemodynamic changes that occur in the patientpopulation operated for a lower segment cesarean section (LSCS), when they are given 0.5%hyperbaric bupivacaine versus 0.5% isobaric bupivacaine as used for spinal anesthesia.Study Design: Prospective double blind randomized trial. Period: 6 months duration fromApril 2014 to September 2014. Setting: A tertiary care hospital in the city of Karachi, Pakistan.Method: The study population consisted of 60 patients belonging to the ASA 1 and ASA 2category, who underwent a lower segment cesarean section, and comparative analysis ofthe efficacy and associated hemodynamic changes of hyperbaric with isobaric bupivacaine.The patient population was segmented into two groups both groups containing 30 patients,group A receiving hyperbaric bupivacaine 0.5% as 2.5ml ( 12.5mg dose ) and the secondgroup designated as, group B receiving isobaric bupivacaine 0.5% as 2.5ml ( 12.5mg dose)intrathecally. The resultant sensory and motor blockade was determined using pin prick andbromage scale respectively. Results: There was a significant difference found among the twogroups under study, when compared at 3min interval regarding the sensory blockade. The levelof T6 block was reached in 33.33% (n=10) patients belonging to group A and 56.66% (n= 17)patients in group B. It was observed that there was no significant change among the two groupsat 5min interval regarding sensory and motor blockade respectively. The immediate sensoryblockade with isobaric bupivacaine in group B produced greater decrease in the systolic andmean arterial blood pressure when contrasted with hyperbaric bupivacaine in group A at 5mininterval, but after time interval of 45min there was no statistically significant change observed.Conclusions: According to our study the effects of isobaric bupivacaine were more significantlypredictable; hence have a higher efficacy, when contrasted against hyperbaric bupivacainein lower section cesarean section spinal anesthesia. Quick sensory blockade with isobaricbupivacaine was associated with more decrease in blood pressures when contrasted with thehyperbaric bupivacaine, but this result is not statistically significant.

scholarly journals Comparative study of hyperbaric 0.5% bupivacaine and hyperbaric 0.5% bupivacaine with low dose dexmedetomidine in spinal anaesthesia

2017 ◽  
Vol 6 (2) ◽  
pp. 410
Author(s):  
Shriganesh D. Kamat ◽  
Nitin N. Puram ◽  
Prakash R. Dhumal ◽  
Pushpa I. Agrawal ◽  
Jaiprakash B. Ramanand ◽  
...  
Keyword(s):  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Low Dose ◽  
Control Group ◽  
Spinal Block ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Group B ◽  
Randomised Controlled

Background: Spinal anaesthesia remains one of the basic techniques in the arsenal of modern anaesthesiology despite the waxing and waning of its popularity over last 100 years since its introduction into clinical practice.It avoids biochemical and metabolic changes consequent to the stress of general anesthesia for surgery as well as provides near optimal conditions for surgery. In present study, we tried to study effectiveness of intrathecal 0.5% heavy bupivacaine alone with Dexmedetomidine as an adjuvant to intrathecal 0.5% heavy bupivacaine for lower limb and lower abdominal surgeries.Methods: The present study was conducted in the department of anaesthesiology from December 2011 to September 2013.This study was a prospective, randomised controlled, single blind, study conducted in 100 patients of ASA grade I and II undergoing elective surgeries under spinal anaesthesia. The patients were divided randomly into two groups, containing 50 patients in each group. Dosages of drugs selected are divided as Group B: Patients received 3 ml of 0.5% hyperbaric bupivacaine (15mg) and Group BD: Patients received 3 ml of 0.5% hyperbaric bupivacaine (15mg) plus 10 µg Dexmedetomidine. Spinal block characteristics, Mean arterial pressure, Mean pulse rate, sedation and side effects were studied during intra-operative and postoperative period.Results: It was found from present study that in Dexmedetomidine group time to reach T10 sensory blockade and complete motor blockade was earlier and a higher level of sensory blockade compared to control group achieved. Duration of sensory, motor blockade and duration of analgesia was significantly prolonged in the Dexmedetomidine group compared to the control group. Hemodynamic parameters were preserved both intra-operatively and postoperatively. However there were a small percentage of patients who developed hypotension and bradycardia which were easily managed without any untoward effect. Hence Dexmedetomidine is a better neuraxial adjuvant for providing early onset of sensory and motor blockade, prolonged sensory blockade and post operative analgesia and adequate sedation.Conclusions: Intrathecal low dose Dexmedetomidine in a dose of 10µg along with 0.5% hyperbaric bupivacaine is an addition into anaesthesiologist's armamentarium for spinal anaesthesia in patients undergoing elective lower abdominal and lower limb surgeries.

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