scholarly journals Comparison of two different doses of dexmedetomidine (0.25 mcg/kg and 0.5 mcg/kg) in prolonging duration of spinal anaesthesia and postoperative analgesia in patients undergoing trans urethral resection of prostate: a prospective randomized double blinded study

2021 ◽  
Author(s):  
Anil K. Bhiwal ◽  
Karuna Sharma ◽  
Vikram S. Rathore ◽  
Chintan M. K. Patel ◽  
Alka Chhabra ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Spinal Anaesthesia ◽  
Postoperative Analgesia ◽  
Motor Block ◽  
Statistical Significance ◽  
Sensory Block ◽  
Mean Value ◽  
Spinal Block ◽  
Rescue Analgesia ◽  
Different Doses

Background: Trans urethral resection of prostate (TURP) under spinal anaesthesia (SAB) in elderly with associated cardio-pulmonary, endocrine or other co-morbidities induces detrimental physiological and psychological stress response to surgery and anaesthesia. Proper sedation during spinal anaesthesia can reduces this response. Aim of this study was to compare the characteristics of spinal block, hemodynamic changes, and postoperative analgesia, following administration of intravenous DMT (0.25 mcg/kg and 0.5 mcg/kg) in elderly patients undergoing TURP under SAB.Methods: Sixty-eight patients were randomly allocated to two groups of 34 patients each. After giving spinal anaesthesia patients received two different doses of dexmedetomidine intravenously; 0.25 mcg/kg (Group D25) and 0.50 mcg/kg (Group D50) respectively. Drugs were given slowly in dilution of 10ml normal saline. Patients were monitored for intraoperative haemodynamics, sensory and motor block characteristics and postoperative analgesia in terms of VAS (visual analogue scale) and first and total dose of rescue analgesic.Results: Mean value of lowest HR in Group D50 and D 25 was comparable (p=0.11) and time taken to achieve lowest HR was also comparable (p=0.13). Mean value of lowest SBP, DBP and MAP were lower in Group D50 than in Group D25 but the difference did not reach statistical significance (p=0.52,0.95 and 0.41 respectively). Onset of sensory block was comparable between the two groups, p=0.62. Maximum sensory block was achieved significantly earlier in Group D50 (10.64±2.75 min versus 12.94±3.04 min in Group D25), p=0.0012. Group D50 patients achieved Bromage score 3 earlier (10.735±1.797 min) than group D25 (12.794±2.52 min) (p=0.00). Recovery from motor block was found earlier in Group D25 group (141.325±4.97 mins) compared to Group D50 (154.41±8.143 mins). Group D50 reported significantly higher sedation than group D25 (p=0.00). Group D25 reported more pain at 4 hours compared to Group D50 (VAS -4.705±0.462 versus 2.588±1.478). Time of requirement of first rescue analgesia was delayed in Group D50 (270.59±50.78 mins) than in Group D25 (172.50±10.46 mins), p=0.000.Conclusions: Dexmedetomidine is effective in relieving anxiety in elderly patients undergoing TURP under spinal anaesthesia. Dose of 0.50 mcg/kg is more effective than 0.25 mcg/kg without increasing the risk of adverse effect. 

scholarly journals Influence of injection rate of hyperbaric bupivacaine 0.75% on spinal anaesthesia in elderly patients with lower limb orthopaedic surgeries. A randomized controlled trial.

2019 ◽  
Vol 26 (08) ◽  
pp. 1251-1255
Author(s):  
Manzoor Ahmed Faridi (Retd) ◽  
Shaheen Mahmood ◽  
Muhammad Safi ur Rehman
Keyword(s):  
Elderly Patients ◽  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Motor Block ◽  
Sensory Block ◽  
Injection Rate ◽  
Ethical Review ◽  
Sensory Level ◽  
Double Blind Study ◽  
Hyperbaric Bupivacaine

To determine the effect of speed of hyperbaric bupivacaine (0.75%) injection on clinical characteristics of spinal anaesthesia in elderly patients undergoing lower limb orthopaedic surgeries. Study Design: Prospective, randomized, double-blind study. Setting: This study was conducted in the operating theatre of Fauji Foundation Hospital, Rawalpindi. Period: August 2018 - March 2019. Materials and Methods: 60 elderly patients undergoing lower limb orthopaedic surgery were randomized into two groups based on injection rate (fast and slow). 1.5 ml of 0.75% hyperbaric bupivacaine was injected over 5 seconds (fast group) and 50 seconds (slow group). Study was undertaken after taking permission from institutional ethical review committee. Level of sensory block, motor block, and systolic blood pressure were recorded at pre-specified intervals. Incidences of hypotensive episode, nausea, phenylephrine and antiemetic use were also documented. Results: Our study did not reveal any difference in maximum level of sensory block attained (fast = median T4, interquartile range [T4–T6] vs slow = T4 [T4–T6], P = 0.77). There was no difference in mean time (minutes) to reach T10 sensory level (fast = 2.5 ± 1.2 vs slow = 2.2 ± 0.8, P = 0.27); maximum sensory level (fast = 4.2 ± 1.5 vs slow = 3.8 ± 1.2, P = 0.26) and maximum motor block level (min) (fast = 5.9 ± 1.4 vs slow = 5.7 ± 1.2, P = 0.56). The rate of hypotension (fast = 8/30 vs slow = 4/30, P = 0.33), nausea (fast = 5/30 vs slow = 3/30, P = 0.99) and phenylephrine use (fast = 5/30 vs slow = 3/30, P = 0.71) and antiemetic requirement (fast = 1/30 vs slow = 2/30, P = 0.99) was also alike. Conclusion: There is no effect of injection speed of intrathecal (0.75%) bupivacaine on the clinical features of spinal anaesthesia in older patients undergoing lower limb orthopedic surgery.

scholarly journals SITTING VERSUS LATERAL POSITION FOR INDUCTION OF SPINAL ANESTHESIA IN ELDERLY PATIENTS – A RANDOMIZED CONTROLLED TRIAL

2017 ◽  
Vol 10 (2) ◽  
pp. 262
Author(s):  
Showkat Hussain Tali ◽  
Showkat Ahmad Bhat ◽  
Kumar Nm ◽  
Shagufta Yousuf
Keyword(s):  
Randomized Controlled Trial ◽  
Elderly Patients ◽  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Motor Block ◽  
Controlled Trial ◽  
Sensory Block ◽  
Lateral Position ◽  
Hemodynamic Parameters ◽  
Randomized Controlled

Objectives: To compare the effect of induction position (sitting versus lateral) for spinal anaesthesia in the elderly patient on hemodynamic, sensory block and motor block characteristics and patient satisfaction.Material and methods: Randomized controlled trial of patients undergoing spinal anaesthesia for lower abdominal, pelvic, lower limb and urological surgeries aged more than 60 years. Hyperbaric Bupivacain (0.05%) was injected into the spinal space while the patients were either in sitting or lateral position. Effects on hemodynamic parameters, sensory block and motor block characteristics and patient satisfaction were analysed.Results: Induction position for spinal anaesthesia does not affect the hemodynamic parameters and incidence of adverse effects when adequate preloading is done. There was no statistically significant difference in the sensory level and motor level achieved. However lateral position appears to be more comfortable for elderly patients (P= 0.03).Conclusions: Induction position for administration of spinal anaesthesia has no effect on hemodynamic parameters or block characteristics except that patients feel more comfortable in lateral position.Keywords: Spinal anesthesia, Induction position, Hyperbaric bupivacaine.

scholarly journals Comparison of Morphine and Clonidine as Adjuncts to Bupivacaine in Spinal Anaesthesia- A Double Blind Randomised Control Trial

2020 ◽  
Author(s):  
Dattaraj Satish Sinai Sukhthanker ◽  
Yvonne Menezes ◽  
Bhagyashri Ramnath Kanekar ◽  
Minu George
Keyword(s):  
Spinal Anaesthesia ◽  
Postoperative Analgesia ◽  
Motor Block ◽  
Sensory Block ◽  
Randomised Control Trial ◽  
Controlled Study ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Preservative Free

Introduction: Spinal anaesthesia is a preferred choice for infraumbilical surgery. Various drugs have been added intrathecally to augment analgesia in the postoperative period. Morphine an opiate was among the first to be introduced. More recently the alpha-2 agonist Clonidine. Aim: To compare Clonidine and Morphine as adjuncts to bupivacaine in spinal anaesthesia on the quality of the block, the duration of postoperative analgesia, haemodynamic changes and complication. Materials and Methods: In this randomised double blind controlled study, one hundred patients between age 20-40 years of age and American Society of Anaesthesiologists (ASA) physical status 1 and 2 undergoing lower limb Orthopaedic procedures were studied to compare the effect of preservative free morphine (100 mcg) (Group BM) and clonidine (30 mcg) (Group BC) as an adjunct to 0.5% bupivacaine in spinal anaesthesia. Group BM received a mixture of 2.6 mL (13 mg) of hyperbaric bupivacaine (0.5%) with 0.1 mL of preservative free Morphine and 0.1 mL 0.9% saline. Group BC received a mixture of 2.6 mL (13 mg) of hyperbaric bupivacaine (0.5%) with 0.2 mL of clonidine (30 mcg).Total volume of solution in both the groups was 2.8 mL. The groups were compared for the onset and duration of sensory and motor blockade. Duration of analgesia, Sedation, Haemodynamic variations viz., Pulse rate, blood pressure and complications. Data obtained was analysed using Student t-test, Pearson chi-square test and ANOVA as appropriate. Results: Onset of sensory block was faster and duration of the sensory as well as motor block was more after addition of Clonidine (30 μg) to bupivacaine in spinal anaesthesia. The duration of postoperative analgesia was significantly prolonged to 10-13 hours in patients receiving Bupivacaine and morphine combination as compared to 6-8 hours noted in patients receiving Bupivacaine and Clonidine only. Incidence of hypotension, bradycardia, shivering, nausea and vomiting was not statistically significant. None of the patients in both groups showed any other side effects like respiratory depression, hypoxia, excessive sedation or any other spinal consequences. Conclusion: Clonidine improves the quality of spinal anaesthesia in terms of faster onset of sensory block and longer duration of sensory as well as motor block compared to morphine, when added as an adjunct. However, the duration of postoperative analgesia was prolonged more with the addition of Morphine compared to Clonidine.

scholarly journals 050419-OA- Spinal-Beena

2019 ◽  
pp. 162-167
Author(s):  
Tariq H Khan
Keyword(s):  
Spinal Anaesthesia ◽  
Motor Block ◽  
Sensory Block ◽  
Primary Objective ◽  
Spinal Block ◽  
Hemodynamic Parameters ◽  
Hyperbaric Bupivacaine ◽  
Voiding Function ◽  
Group A ◽  
Group B

Background: Spinal anaesthesia is a reliable and safe technique for infra-umbilical surgeries. Preservative-free 2-chloroprocaine has re-emerged for use in spinal anaesthesia. We compared onset and duration of sensory block with intrathecal use of 1% 2-Chloroprocaine (30 mg) or 0.5% Hyperbaric Bupivacaine (15 mg) as primary objective. Secondary objectives being onset and duration of motor block, duration of analgesia, time to return of voiding function, hemodynamic parameters and side effects. Materials and Methods: 90 patients of age group 18-60 years, either sex, belonging to ASA physical status I/II undergoing infra-umbilical surgeries were randomly divided into two groups, 1% 2-chloroprocaine Group A (n=45) and 0.5% hyperbaric bupivacaine Group B (n=45). Each group received intrathecally either 30 mg of 2-Chloroprocaine or 15 mg of hyperbaric bupivacaine 15 mg. For statistical analysis unpaired-t-test and chi-square test were used.  Results: Earlier onset and shorter duration of sensory block were observed in Group A as compared to Group B respectively (p < 0.001). Similarly, onset was earlier and duration of motor block, duration of analgesia and time to return of voiding function were shorter in Group A as compared to Group B respectively (p < 0.001). Hemodynamic parameters (HR, MAP) were comparable in both groups. Conclusion: Intrathecal 1% 2-Chloroprocaine 30 mg provides spinal anaesthesia of adequate duration for infra-umbilical surgeries with the advantage of earlier onset and faster regression of spinal block resulting in earlier voiding with stable hemodynamics as compared to 0.5% hyperbaric bupivacaine 15 mg. Keywords: Infra-umbilical surgeries, 2- chloroprocaine, Bupivacaine, Spinal Anaesthesia, Sensory Block, Motor Block.

scholarly journals Comparison of Three Different Doses of Nalbuphine as Adjuvant to Intrathecal Hyperbaric Bupivacaine in Knee Joint Surgeries

2021 ◽  
Vol 8 (15) ◽  
pp. 950-955
Author(s):  
Amit Pradhan ◽  
Ranjitha Kusumanchi ◽  
Pulak Priyadarshi Padhi ◽  
Saswati Das
Keyword(s):  
Postoperative Pain ◽  
Adverse Effects ◽  
Knee Joint ◽  
Spinal Anaesthesia ◽  
Motor Block ◽  
Onset Time ◽  
Sensory Block ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Different Doses

BACKGROUND Postoperative pain is the most challenging task in patients undergoing knee joint surgeries under spinal anaesthesia. Spinal anaesthesia with bupivacaine provides adequate intraoperative conditions but falls short in providing prolonged postoperative pain relief. Intrathecal opioids are synergistic with local anaesthetics and intensify the sensory block without affecting the sympathetic block. This study intends to compare three different doses of intrathecal nalbuphine as an adjuvant to 0.5 % hyperbaric bupivacaine and determine the optimal dose in knee joint surgeries. METHODS A double-blind comparative study was conducted in one hundred and twenty American Society of Anaesthesiologists (ASA) I and II patients undergoing knee joint surgeries in a randomised prospective way. The patients were randomly allocated to A, B, and C groups who received 0.4, 0.8 and 1.2 mg nalbuphine respectively added to 12.5 mg of 0.5 % hyperbaric bupivacaine. The onset, duration of block, duration of effective analgesia, Visual Analogue Scale (VAS) score, and the incidence of adverse effects were studied and compared between the groups. RESULTS The mean onset time of sensory and motor block of group B and C was significantly faster as compared to the onset in group A. The duration of sensory, motor blockade and duration of analgesia were highest with 1.2 mg of nalbuphine followed by 0.8 and 0.4 mg (P < 0.05). VAS readings were comparable in all the groups. Hemodynamic variability among the three groups was comparable. Incidence of adverse effects was highest in group C when compared with others, although it was statistically insignificant (P > 0.05). CONCLUSIONS Nalbuphine in a dose of 0.8 mg when added to 0.5 % hyperbaric bupivacaine for subarachnoid block in patients undergoing knee joint surgeries provides excellent analgesia, prolonged duration of sensory block and motor block, with minimal adverse effects. KEYWORDS Local Anaesthesia, Opioid, Postoperative Pain, Orthopaedic Surgeries

A COMPARATIVE STUDY OF 0.5 % BUPIVACAINE WITH FENTANYL VERSUS 0.75% ROPIVACAINE WITH FENTANYL IN EPIDURALANESTHESIA FOR ABDOMINAL HYSTERECTOMY

2021 ◽  
pp. 71-73
Author(s):  
Pravin Vijayan ◽  
Debarshi Jana
Keyword(s):  
Motor Block ◽  
Sensory Block ◽  
Local Anaesthetics ◽  
Abdominal Hysterectomy ◽  
Controlled Study ◽  
Rescue Analgesia ◽  
Study Results ◽  
Duration Of Surgery ◽  
Group B ◽  
Time To Onset

INTRODUCTION Abdominal hysterectomy (AH) is a quite common gynaecological surgical procedure and electively done under central neuraxial blockade. AH is performed for malignant as well as benign indications such as uterine leiomyoma, persistent vaginal bleeding, or pelvic organ prolapse. AIMS AND OBJECTIVES Compare the onset of motor and sensory block. Find out the duration of the sensory and motor blockade. Observe intraoperative hemodynamic changes and assess post-operative analgesia requirements in 24 hour. Duration of analgesia assessed by requirement of rst rescue analgesic. Observe any untoward incident during intraoperative and post-operative period and managed accordingly MATERIALS AND METHODS Study Area: Department of Anesthesiology & critical care, DARBHANGAMEDICALCOLLEGE AND HOSPITAL. Study Population: Adult patients (30- 65 years) undergoing elective abdominal hysterectomy with regional anaesthesia were included for this study. Study Period:January 2019 to March 2020 Sample Design: Subjects were divided into two groups (n=35) equal in numbers and they sampled as per computerized randomization chart. These patients were divided into two groups, group B (with epidural 0.5% bupivacaine and 100g fentanyl) and group R (with epidural 0.75% ropivavaine and 100g fentanyl). Study Design: Prospective, open, randomized, controlled study. RESULTS: In Our study showed that 3.38kg/m2 and 24.86 3.60 kg/m2in group B and R respectively. The duration of surgery was 100.86 9.35minutes and 98.86 8.32 minutes and the duration of stay, was4.86 0.81days and 4.60 0.914 days in group B and group R respectively. Now with comparison of both groups, time to onset of sensory block (uptoT6) has signicant variation. But the other parameters namely, time to onset of motor block, two segment regression or duration of sensory block, rescue analgesia timing and complete motor recovery time were comparable and not signicant statistically in both groups. SUMMARY & CONCLUSIONS To conclude that in the present study using 0.5% bupivacaine with fentanyl and 0.75% ropivacaine with fentanyl epidurally, ropivacaine produced an earlier onset but similar duration of sensory block. The onset, quality and duration of motor block werecomparable in both the groups. It is important that new local anaesthetics with lower cardiotoxic property are adopted to ensure that regional techniques using large amounts of local anaesthetics remain safe with minimal complications. The recovery prole of ropivacaine may be useful where prompt mobilization is require

scholarly journals The efficacy and safety of intrathecal bupivacaine alone versus bupivacaine combined with magnesium sulfate in adults using spinal anesthesia: a meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Mi-Zhou Wang ◽  
Rui Dong ◽  
Li-Na Jia ◽  
Deng-Bin Ai ◽  
Jian-Hua Zhang
Keyword(s):  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Magnesium Sulfate ◽  
Motor Block ◽  
Meta Analysis ◽  
Sensory Block ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Rescue Analgesia ◽  
Randomized Controlled

Abstract Background: Several studies have investigated the effects of intrathecal magnesium sulfate as an adjuvant for bupivacaine; however, their conclusions are inconsistent. Therefore, it is necessary to conduct a meta-analysis on this topic.Methods We searched Pubmed, EMBASE (OvidSP) and Cochrane Central Register of Controlled Trials (CENTRAL) for randomized controlled trials (RCTs) comparing the effect of intrathecal bupivacaine combined with magnesium sulfate versus bupivacaine alone in adults using spinal anesthesia.Results Eighteen studies that met our inclusion criteria were included in our analysis. We found that the addition of intrathecal magnesium sulfate to bupivacaine provided a longer duration of analgesia (SMD 0.99; 95% CI [0.45, 1.52], P = 0.0003, I2 = 93%), prolonged the duration of sensory block (MD=106.69; 95% CI, 60.93-152.45; P<0.00001), delayed the onset of sensory block (SMD 1.20; 95% CI [0.65, 1.75], P =<0.0001, I2 = 91%) and motor block (SMD 1.46; 95% CI [0.23, 2.69], P =0.02, I2 = 96%), decreased the requirement for rescue analgesia (SMD -0.81; 95% CI [-1.06, -0.56], P < 0.00001, I2 = 11%). For duration of motor block, and incidence of postoperative adverse events (such as nausea and vomiting, hypotension, bradycardia, pruritus, shivering and neurological deficit), no statistically differences were observed between the 2 groups.Conclusions Our meta-analysis demonstrated that intrathecal magnesium sulfate combined with bupivacaine prolongs the dusration of analgesia, without an impact on the adverse events. However, the quality of evidence was very low when using GRADE to assess it. Given adverse effects before use, more high-quality trials with large samples are required before magnesium sulfate is routinely used as a intrathecal adjunct.

scholarly journals Intrathecal 0.5% Isobaric Bupiv Acaine Versus 0.5% Isobaric Ropiv Acaine for HIP Surgeries

2021 ◽  
pp. 312-315
Author(s):  
M. Raj
Keyword(s):  
Motor Block ◽  
Sensory Block ◽  
Mean Value ◽  
Value Of Time ◽  
Sensory Motor ◽  
The Mean ◽  
Group B

The sensory motor block for ropivacaine starts at 6.4 minutes and similarly for bupivacaine is 3.32 minutes. The sensory block for ropivacaine is from ranges from T8-T12 and for bupivacaine its T4 - T8 level. The time taken for motor block is 203.8 and for group R its 142.9min. In group B, the mean value of time taken for two segment regression is 97.9 minutes. The time taken for group R to regress is 63.7. In Group its 4. 70 minutes. In Group R the    mean onset of motor block is 9.40 minutes.

scholarly journals Comparison of Intrathecal Fentanyl and Butorphanol as an Adjuvant to Intrathecal Bupivacaine 0.5% in Infraumbilical Surgeries- A Randomised Double Blind Study

2020 ◽  
Author(s):  
Sandip Roy Basunia ◽  
Prosenjit Mukherjee ◽  
Md Bakir Hossain Munshi
Keyword(s):  
Spinal Anaesthesia ◽  
Motor Block ◽  
Controlled Trial ◽  
Sensory Block ◽  
P Value ◽  
Double Blind Study ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Group A ◽  
Group B

Introduction: Neuraxial opioids are widely used as adjuvants to local anaesthetic as they improve quality and duration of block. Neuraxial opioids like Butorphanol and Fentanyl allow prolonged analgesia in the postoperative period and faster recovery from spinal anaesthesia. Aim: To compare the safety and efficacy of Butorphanol and Fentanyl combined with bupivacaine for spinal anaesthesia in infraumbilical surgeries. Materials and Methods: The present study was a randomised controlled trial in which 110, ASA I and II patients of either sex who underwent elective infraumbilical surgeries under spinal anaesthesia were selected. Patients were allocated randomly into two groups A (n=55) and B (n=55). Group A (F) received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg (3 mL) with fentanyl 25 microgram (0.5 mL) to make it total 3.5 mL. Group B (B) received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg (3 mL) with butorphanol 250 microgram (0.25 mL) and Normal Saline (NS) 0.25 mL to make it total 3.5 mL. Heart Rate (HR), Systolic and Diastolic Blood Pressure (SBP, DBP), two segment regression time of sensory block, motor block were assessed at preset intervals. Chi-square test or Fischer’s-exact test were used and a p-value ≤0.05 was considered as statistically significant. Results: Mean of two segment sensory regression time of Group A was 41.94±1.73 minutes and Group B was 50.56±4.43 minutes (p<0.0001). Time to onset of motor block in Group A was 5.28±.32 minutes and Group B was 5.27±.32 minutes (p=0.96). Mean duration of motor block in Group A was 81.23±4.87 minutes and Group B was 109.83±2.61 minutes (p<0.0001). Time to rescue analgesic was 289.27±7.37 minutes in Group A and 378.41±10.25 minutes in Group B (p<0.0001). HR, SBP and DBP were comparable among the groups. Conclusion: Intrathecal bupivacaine-butorphanol mixture was clinically better as it provided longer duration of analgesia with lesser incidences of pruritus and nausea/vomiting compared to intrathecal fentanyl-bupivacaine mixture.

scholarly journals A Comparative Study of Intravenous Clonidine and Dexmedetomidine on Characteristics of Bupivacaine Spinal Anesthesia

2020 ◽  
Vol 5 (1) ◽  
pp. 165-167
Author(s):  
Shailender Bamel ◽  
Nandita Kad ◽  
Vinit ◽  
Shilpa Popli ◽  
Devender Chahal
Keyword(s):  
Single Dose ◽  
Spinal Anesthesia ◽  
Postoperative Analgesia ◽  
Orthopedic Surgery ◽  
Lower Limb ◽  
Motor Block ◽  
Sensory Block ◽  
Well Being ◽  
Control Group ◽  
Sensory Blockade

Background: Spinal anesthesia with bupivacaine is administered routinely for lower abdominal and lower limb surgeries. The ensuing nerve block is sufficient to ensure patient’s well being, while motor block facilitates the surgeon’s work. In patients receiving spinal anaesthesia, with local anesthetic agents like bupivacaine, the addition of another drug as adjuvant prolongs the analgesia. The present study is designed to study the effect of dexmedetomidine (D) and Clonidine (C) on the duration of motor and sensory block as well as postoperative analgesia by intrathecal bupivacaine in patients undergoing lower limb orthopedic surgery. Subjects and Methods: This study was carried out on 90 patients in the age group of 18 to 50 years, belonging to the American Society of Anesthesiologists(ASA) physical status I and II presenting for lower limb orthopedic surgery were included in the study. Patients were divided randomly into 3 groups. Group D received 1μg kg-1of dexmedetomidine, group C received 2 μg kg-1 of clonidine and group NS Control group received an equivalent amount of normal saline. Results: From the current study we observed that single dose of 1 μg kg-1 dexmedetomidine over 20 minutes started 20 minutes after spinal block and a single dose of 2 μg kg-1 Clonidine resulted in a significant prolongation of time to two-segment regression, postoperative analgesia,  sensory block and motor block with the maintenance of hemodynamic parameters. Intravenous dexmedetomidine was more effective than Clonidine at the prolongation of time to two-segment regression, postoperative analgesia, sensory block and motor block of spinal anesthesia with 0.5% hyperbaric bupivacaine. Conclusion:  Dexmedetomidine (1μg kg-1) in comparison to Clonidine (2 μg kg-1) and placebo is far more effective in the motor blockade, sensory blockade and duration of postoperative analgesia.

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