Haemodynamic Effects and Complications of Unilateral Spinal versus Standard Spinal Anesthesia in Elderly with Low Ejection Fraction Undergone Lower-Limb Surgery

Background: Cardiovascular system may be profoundly affected by spinal anaesthesia due to unavoidable sympathetic blockade which is more prominent in elderly.A restricted sympathetic block during spinal anesthesia may minimize hemodynamic changes.Objective: To assess whether a unilateral spinal anaesthesia using 0.5% hyperbaric bupivacaine will restrict the sympathetic block to avoid the undesired cardio vascular effects.Materials and method: In this prospective study 60 ASA Ill and IV patients aged between 60-90 years undergoing unilateral lower limb surgery were included. Patients were divided into two groups. In group-A, dural puncture was performed with the patient in the lateral decubitus position with 1.5 mL of hyperbaric bupivacaine. In group-B, it was performed with the patient in a seated position using 1.5 mL hyperbaric bupivacaine. Each patient was then placed in supine position. The speed of injection was 1 mL/30s. Patients were placed in the lateral position with operated side down and kept in this position for 10 minutes. Motor and sensory levels were assessed, and haemodynamic alterations were monitored just after block, 5, 10, 15 and 30 minutes of spinal anaesthesia.Results: The demographic data were found similar in both groups. The time to the onset of the sensory and motor block was significantly shorter in group-B. The duration of motor and sensory block was significantly shorter in group-A. Haemodynamically all the parameters revealed better out come in unilateral spinal anesthesia. The incidence of complications (nausea, headache, and hypotension) was also lower in group A.Conclusion: When unilateral spinal anesthesia was performed using a low-dose, low-volume and low-flow injection technique, it provides adequate sensory-motor block and helps to achieve stable hemodynamic parameters during surgery on a lower limb. Furthermore, this technique avoids unnecessary paralysis on the non-operated side.Delta Med Col J. Jan 2017 5(1): 20-24

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Compare the Analgesic Efficacy of Dexmedetomidineand Fentanyl as an Adjuvant to Bupivacaine for Lower Limb Surgery

10.53350/pjmhs211562153 ◽

2021 ◽

Vol 15 (6) ◽

pp. 2153-2155

Author(s):

Arshi Naz ◽

Mirza Shahzad Baig ◽

Vijai Kumar ◽

Samita S Khan ◽

Sidra Javed ◽

...

Keyword(s):

Spinal Anaesthesia ◽

Lower Limb ◽

P Value ◽

Hyperbaric Bupivacaine ◽

Rescue Analgesia ◽

Sensory Blockade ◽

Significant Difference ◽

Lower Limb Surgery ◽

Group A ◽

Group B

Objective: To compare the analgesic effectiveness of Dexmedetomidine and Fentanyl as an adjuvant to 0.5% Bupivacaine in spinal anaesthesia for patients undergoing lower limb surgery. Study Design: Randomized controlled trial. Place & Duration:The study was conducted at department of Anesthesia, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi for duration from 15thJuly2020 to 15thFebruary 2021. Methods: In this study 52 patients of both genders undergoing lower limb surgeries were included. Patient’s ages were ranging from 20 to 70 years. All the patients were divided into two Groups. Group A included 26 patients and received Inj. Dexmedetomidine 10 μg in 0.5ml normal saline with 12.5mg of 0.5% hyperbaric bupivacaine, Group B had 26 patients and received 25mg fentanyl with 12.5mg of 0.5% hyperbaric bupivacaine. Time to achieve T10 blockade, time to first rescue analgesia were examined and compare between both groups. All the statistical data was analyzed by SPSS 24.0. P-Value <0.05 was significantly considered. Results: Mean age of group A was 40.52±12.28 years and in group B it was 40.14±13.34 years. There were 18 (69.23%) male patients and 8 (30.77%) females in group A while in Group B 19 (73.08%) patients were male and 7 (26.92%) were females. No significant difference was observed between both groups regarding time to T10 blockade with p-value >0.05. A significant difference was found regarding time to rescue analgesia, in Group A it was 426.58±92.44 minutes and in Group B, it was 206.44±48.47 minutes (p-value <0.0001). Patients’ satisfaction was high in dexemedetomidine group as compared to fentanyl group. Conclusion: Dexmedetomidine 10 μg with 0.5% bupvicaine showed better effectiveness regarding time to first rescue analgesia as compared to fentanyl. No significant difference was observed regarding time to sensory blockade between both medications. Keywords: Dexmedetomidine, Fentanyl, Spinal Anaesthesia, Lower Limb Surgery, Sensory Block, Analgesia

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Isobaric levobupivacaine a better and safer substitute for spinal anaesthesia in patients undergoing prolonged lower abdominal and lower limb surgeries

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20183654 ◽

2018 ◽

Vol 6 (9) ◽

pp. 3111

Author(s):

Wasimul Hoda ◽

Abhishek Kumar ◽

Priodarshi Roychoudhury

Keyword(s):

Spinal Anesthesia ◽

Spinal Anaesthesia ◽

Lower Limb ◽

Motor Block ◽

Sensory Block ◽

Double Blind Study ◽

Double Blind ◽

Sensory Blockade ◽

Group A ◽

Group B

Background: Bupivacaine being the drug of choice for spinal anaesthesia is associated with serious cardiac toxicity. Levobupivacaine and ropivacaine, both being the two S enantiomers of bupivacaine can be a safer alternatives with better cardiovascular safety. Hence, the clinical efficacy of both were assessed and compared in patients undergoing spinal anesthesia.Methods: A prospective randomized controlled double blind study was done in 68 adult posted for elective lower abdominal and lower limb surgeries under spinal anesthesia. They were randomized into 2 groups. About 3ml isobaric levobupivacaine 0.5% (15mg) was given in group A and 3ml isobaric ropivacaine 0.5% (15mg) was given in group B. Onset, duration of sensory and motor blocks, time for maximum sensory and motor block, time for 2 segment sensory regression and haemodynamic parameters were recorded and analyzed.Results: All patients achieved a sensory block of T10 dermatome. Onset of sensory blockade at T10 was similar in both groups, group A (5.71±1.31min) and group B (5.94±1.72min). Time from injection to two dermatomal regression was 129.68±15.54min in group A and 111.38±22.35min in group B. Onset of Bromage score of 1 in group A was 4.68±1.27min and in group B was 6.44±1.64min. The mean duration of motor and complete motor block was prolonged in group A patients (197.74±18.51min, 168.82±17.90 min) as compared to group B (131.88±20.41min, 106.71±10.85min).Conclusions: Isobaric levobupivacaine was found to be a better and safer substitute for spinal anesthesia in patients undergoing prolonged lower abdominal and lower limb surgeries.

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A Comparison of Oral Gabapentin and Oral Pregabalin as Preemptive Analgesia for Orthopedic Surgery Under Spinal Anaesthesia

PERSPECTIVES IN MEDICAL RESEARCH - 2 ◽

10.47799/pimr.0901.15 ◽

2021 ◽

Vol 9 (1) ◽

pp. 74-78

Author(s):

Neena Jain ◽

Rahul Bankapur ◽

Preeti Lamba ◽

saurav Singh

Keyword(s):

Side Effects ◽

Postoperative Pain ◽

Spinal Anesthesia ◽

Spinal Anaesthesia ◽

Orthopedic Surgery ◽

Lower Limb ◽

Analgesic Efficacy ◽

Double Blind Study ◽

Group A ◽

Group B

Background and Aims: Gabapentin and pregabalin, by decreasing noxious stimulus induced excitatory neurotransmitter release at central nervous system, may attenuate central sensitization and eventually decrease development of postoperative pain. We evaluated preemptive analgesic efficacy of single dose of oral gabapentin 600 mg and pregabalin 75mg for postoperative pain in patients undergoing lower limb orthopedic surgery under spinal anesthesia. Material and methods: A prospective, randomized, double blind study was conducted on 70 patients aged between 18 to 60 years with ASA grade 1 and 2 posted for lower limb surgeries under spinal anaesthesia. Patients were allocated into Group A and Group B receiving oral gabapentin(600mg) and oral pregabalin (75mg) respectively 1.5 hours before surgery. Primary objective was assessing duration and quality of analgesia by Visual Analogue Scale (VAS) score at 2,4,6,8,10,12,16,20 and 24 hours.Secondary objective was to assess total dose of rescue analgesic in first 24 hours, perioperative hemodynamic change and various side effects. Statistical Analysis used: Categorical data was compared using Chi- square test. Quantitative parametric data was analysed using unpaired student t-test. P value < 0.05 was considered statistically significant. Results: Mean duration of analgesia in Group A (10.53 ± 2.686 hours) was longer than Group B (7.943±3.199hr) (P = 0.0006).Mean number of analgesic dosesrequired in first 24 hourswere less in Group A (1.429 ± 0.5021) ascompared to Group B (1.771±0.6897) (P = 0.0202).All patients remained hemodynamically stable with no significant side effects noted in either group. Conclusion: We conclude that preemptive analgesic efficacy of oral gabapentin 600mg is better in comparison to oral pregabalin 75 mg for patients posted for lower limb orthopedic surgeries under spinal anesthesia.

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

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/44242.13949 ◽

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.

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COMPARATIVE STUDY OF HAEMODYNAMIC CHANGES BETWEEN 6% HYDROXYETHYLSTARCH 130/0.4 AND RINGER LACTATE COLOADING IN ELDERLY PATIENTS UNDERGOING LOWER LIMB ORTHOPAEDIC SURGERY UNDER SPINAL ANAESTHESIA

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.289 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Jayanta Chakraborty ◽

Uma Mandal

Keyword(s):

Elderly Patients ◽

Spinal Anaesthesia ◽

Lower Limb ◽

Orthopaedic Surgery ◽

P Value ◽

Ringer Lactate ◽

Lower Limb Surgery ◽

Group A ◽

Group B ◽

Lactate Solution

Background: Anaesthesia for the lower limb surgeries could be either general or regional. Studies had shown that regional anaesthesia for lower limb surgery results in better postoperative outcomes, including improved respiratory function, less nausea vomiting, less pain and lower incidence of deep vein thrombosis. Among all the regional anaesthetic techniques spinal anesthesia remained most preferred technique for its fast, predictable, profound, high quality sensory and motor block. However some complications like hypotension, bradycardia, post dural puncture headache, urinary retention were unavoidable and hypotension remained the most common one and found to be more in the elderly population with incidence of 25–82%. Treating spinal anaesthesia-induced hypotension included intravenous (IV) volume administration. IV Fluid infused before and at the time of spinal anaesthesia was referred to as preloading and coloading respectively. Although merit of coloading and the choice of fluid to be infused had remained a matter of debate, till today no definitive study had indicated any superiority of colloids over crystalloids decisively moreover large amount crystalloids to counter hypotensin remained a threat to the cardiovascular overload for elderly patients. Role of vasopressors in elderly remained controversial too. So this observational prospective study was undertaken to compare the effiicacy of coloading of infusion 6%HES 130/0.4 (colloid) and Ringer Lactate solution (crystalloid) to maintain the intra operative haemodynamics in elderly patients undergoing lower limb orthopaedic surgery under spinal anaesthesia. Objectives: To assess and to compare the efficacy of infusion 6%HES 130/0.4 and infusion Ringer lactate solution coloading in preventing the intra-operative hypotension. Materials and method: On approval of the Ethics Committee of Burdwan Medical College (BMC&H), 80 patients were included and equally divided into two groups group A and group B where groupp A received 6% HES as coloading fluid and groupp B received RL as coloading fluid at the start of spinal anaesthesia. On entering Operation Theatre baseline parameters were noted for each patient and lumbar puncture for spinal anaesthesia was performed following strict aseptic precautions, in sitting position. Upon achieving adequate block episodes of hypotension were noted and treated according to the study protocol. Results: Statistical analysis for Continuous and categorical variables were done using Mann-Whitney U test and Pearson’s Chi Square test accordingly and p values less than 0.05 were considered significant. In group A, 17.5 % patients developed one episodes of hypotension whereas in group B, 37.5% patients developed one episodes of hypotension which was statistically significant with p value 0.0465. In group A none of the patients developed further episodes of hypotension but in group B 5% affected patients developed one more episodes of hypotension and 2.5% affected patients developed two more episodes of hypotension. Average intravenous dose of mephentermine required to treat hypotension was 1.05 mg for group A and 2.70 mg for group B and found to be statistically significant with p value 0.039. Total fluid consumption In group A was 654.95 ml whereas in group B was 976.73 ml and also found to be statistically significant with p value <0.001. Conclusion: The study found that coloading with 6% HES was significantly effective than Ringer Lactate solution in preventing episodes of hypotension in spinal anaesthesia induced elderly patients undergoing lower limb surgery without any noticeable adverse effect. Key Words: Spinal anaesthesia, lower limb surgery, elderly patients, coloading

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A randomized double blind study to compare 1% 2-chloroprocaine and 0.5% hyperbaric bupivacaine in spinal anesthesia for infra-umbilical surgeries

Anaesthesia, Pain & Intensive Care ◽

10.35975/apic.v23i2.1061 ◽

2019 ◽

pp. 162-167

Author(s):

Arvind Khare ◽

Beena Thada ◽

Devraj Yadav

Keyword(s):

Spinal Anesthesia ◽

Motor Block ◽

Sensory Block ◽

Double Blind Study ◽

Hemodynamic Parameters ◽

Hyperbaric Bupivacaine ◽

Double Blind ◽

Voiding Function ◽

Group A ◽

Group B

Background: Spinal anesthesia is a reliable and safe technique for infra-umbilical surgeries. Preservative-free 2-chloroprocaine has re-emerged for use in spinal anesthesia. 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.Methodology: 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 anesthesia 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.Citation: Khare A, Thada B, Yadav D, Mathur V, Singh M. A randomized double blind study to compare 1% 2-chloroprocaine and 0.5% hyperbaric bupivacaine in spinal anesthesia for infra-umbilical surgeries. Anaesth. pain & intensive care 2019;23(2):162-167

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Comparative Study of Hyperbaric Bupivacaine and Isobaric Ropivacaine for Lower Limb Surgery under Spinal Anesthesia

Nepal Medical Journal ◽

10.37080/nmj.65 ◽

2019 ◽

Vol 2 (2) ◽

pp. 22-27

Author(s):

Gunjan Regmi ◽

Rejina Shahi ◽

Kanak Khanal ◽

Kumud Pyakurel ◽

Chetan Bohora ◽

...

Keyword(s):

Heart Rate ◽

Comparative Study ◽

Spinal Anesthesia ◽

Lower Limb ◽

Motor Block ◽

Hyperbaric Bupivacaine ◽

Subarachnoid Block ◽

Arterial Blood ◽

Group I ◽

Lower Limb Surgery

Introduction: Subarachnoid block is commonly employed technique for lower abdominal and lower limb procedures. Bupivacaine and ropivacaine are commonly used local anesthetics for subarachnoid block. The aim of this study is to compare the efficacy and safety of isobaric Ropivacaine over hyperbaric Bupivacaine. Methods: This was a prospective comparative study for a duration of six months. 60 ASA grade I-II adult patients between 16-60 years undergoing lower limb surgery under spinal anesthesia were randomized into two groups. Group I including patients who received 15 mg of hyperbaric bupivacaine 0.5% and group II including patients who received 22.5 mg of isobaric ropivacaine 0.75%. The onset and duration of sensory and motor block and hemodynamics including heart rate (HR), non invasive mean arterial blood pressure (MAP) and respiratory depression were recorded. Data were entered in Microsoft excel and statistical analysis was done by chi square test and T test using SPSS (version 23.0). Results: Both the groups were demographically statistically insignificant. Successful block was attained in all patients in both groups. The sensory onset and motor onset were significantly delayed in the Ropivacaine Group compared to the Bupivacaine Group P<0.001. There was no significant difference in the hemodynamics (heart rate and mean arterial pressure ). Conclusions: Though isobaric ropivacaine provided lesser degree of sensory and motor block with delayed onset compared to hyperbaric bupivacaine, it can effectively and safely used in subarachnoid block in lower limb surgeries without any major hemodynamic changes and adverse effects.

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COMPARISON OF INTRATHECAL DEXMEDETOMIDINE AND MAGNESIUM SULPHATE AS AN ADJUVANT TO 0.5% HYPERBARIC BUPIVACAINE IN LOWER LIMB SURGERY

10.36106/ijar/8301507 ◽

2021 ◽

pp. 1-3

Author(s):

Shaheer Ahmed Siddiqui ◽

Kapil Rastogi ◽

Aamir Laique Khan

Keyword(s):

Magnesium Sulfate ◽

Postoperative Analgesia ◽

Lower Limb ◽

Motor Block ◽

Onset Time ◽

Sensory Block ◽

Hyperbaric Bupivacaine ◽

Block Level ◽

Lower Limb Surgery ◽

Group B

Background: Epidural anesthesia is commonly used for perioperative as well as postoperative analgesia in lower limb surgeries. Adjuvant in spinal anesthesia prolongs the duration of anesthesia as well as postoperative analgesia. In this study we evaluate the effects of intrathecal dexmedetomidine and magnesium sulfate as an adjuvant to 0.5% hyperbaric bupivacaine in lower limb surgeries. Methods: Total 60 patients belonging to ASA I or II aged 24 to 57 years of either sex were included in this study and randomly distributed into two groups. Group (B+M) received intrathecal 100mg magnesium sulfate and Group (B+D) received intrathecal 5.0 mcg dexmedetomidine with hyperbaric bupivacaine 15mg (3ml of 0.5%). Onset and duration of sensory and motor block, duration of analgesia, hemodynamic changes and complications were recorded. Results: The mean Onset time of sensory block at T10 (min.), Time to maximum sensory block level (min.), Time in minutes for complete motor block (min.), Time for Motor Emergence from Bromage 3 (min.), Time for Sensory Emergence and Time for first analgesia (min) were significantly different between groups. Conclusion: The dexmedetomidine as an adjuvant with hyperbaric bupivacaine leads to earlier onset and prolonged duration of both sensory and motor block as compared to magnesium sulfate.

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Clinical Comparative Study between Fentanyl and Dexmedetomidine with Bupivacaine for Lower Limb Surgery in Spinal Anaesthesia

Academia Anesthesiologica International ◽

10.21276/aan.2020.5.1.25 ◽

2020 ◽

Vol 5 (1) ◽

pp. 126-130

Author(s):

Tuhin Vashishth ◽

Sangeeta Varun

Keyword(s):

Spinal Anesthesia ◽

Lower Limb ◽

Motor Block ◽

Sensory Block ◽

Double Blind Study ◽

Hyperbaric Bupivacaine ◽

Double Blind ◽

Block Time ◽

Lower Limb Surgery ◽

Group D

Background: Spinal anesthesia is a preferred technique of choice in infraumbilical surgeries. The spinal anesthesia effect can be improved by adding various adjuvant like Fentanyl, clonidine, dexmedetomidine. Dexmedetomidine is a highly selective alpha 2 adrenergic agonists. The aim of study to compare efficacy and safety between Dexmedetomidine and Fentanyl with Bupivacaine.Subjects and Methods:A prospective randomized, double-blind study was conducted on 100 patient by dividing them into two groups. Group D: 2.5ml (12.5mg) of 0.5% hyperbaric bupivacaine with 5mcg (0.5ml) dexmedetomidine and Group F : 2.5ml(12.5mg) of 0.5% hyperbaric bupivacaine with 2 5mcg(0.5ml) fentanyl. The total volume injected intrathecally was 3.0ml in ASA I and II grade patient undergoing lower limb surgery.Results:Patients in dexmedetomidine groupD had a significantly longer sensory and motor block time than patients in fentanyl group F.The mean time of sensory regression to level S1 was 306.00 ± 13 .32 in group D and 206.14± 16.69 in group F(P<0.001). The regression time of motor block to reach modified Bromage 0 was 257.70±14.61 in group D and 178.54±14.23 in group F(P<0.001).Conclusion:Intrathecal Dexmedetomidine is associated with prolonging motor and sensory block as compare to Fentanyl.

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Evaluation of the Effect of Single Bolus Dose of Intravenous Dexmedetomidine in Spinal Anaesthesia for Lower Limb Surgeries

Birat Journal of Health Sciences ◽

10.3126/bjhs.v5i1.29636 ◽

2020 ◽

Vol 5 (1) ◽

pp. 970-975

Author(s):

Bandana Paudel ◽

Pramod Rai ◽

Robins Tiwari ◽

Sanjay Gautam ◽

Sumitra Paudel ◽

...

Keyword(s):

Spinal Anaesthesia ◽

Lower Limb ◽

Receptor Agonist ◽

Motor Block ◽

Bolus Dose ◽

Hyperbaric Bupivacaine ◽

Single Bolus ◽

Lower Limb Surgery ◽

Single Bolus Dose ◽

Group D

Introduction: The use of intrathecal adjuvants in spinal anaesthesia in enhancing and prolonging it’s action has been well established and is widely used for surgery below the umbilicus. Dexmedetomidine, a selective α2A receptor agonist is a suitable adjuvant due to its selective activity. Objectives: To evaluate the effect of a single bolus dose of intravenous dexmedetomidine as an adjuvant in cases undergoing lower limb surgeries under spinal anaesthesia. Methodology: One hundred patients posted for lower limb surgery under spinal anaesthesia with hyperbaric bupivacaine, were equally divided into two groups. In group D, in addition to spinal, intravenous dexmedetomidine 0.5mcg/kg over 10 min was given whereas group C patients received spinal and intravenous normal saline . Results: The onset of sensory and motor block was faster in group D (2.09 ± 0.71 min, 3.18 ± 1min)compared to group C (3.5 ± 0.82 min, 6.19 ± 1.87 min) which was statistically significant . The duration of sensory and motor block was also significantly prolonged in Group D (174.5 ± 14.04 min, 133.4 ± 10.42 min) as compared to Group C(138.2 ± 11.51 min, 120.4 ± 8.8 min).The duration of analgesia in Group D (225.3 ±20.11 min)was prolonged when compared to Group C (168.3 ± 15.11). Conclusion: Intravenous dexmedetomidine as a single bolus dose before spinal anaesthesia can fasten the onset of sensory and motor block, prolongs the duration of sensory and motor block and also increased the duration of analgesia.

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