ABSTRACT
Background: Knowledge and use of adjuvant drug therapy has rendered neuraxial analgesia more effective in the management of both acute and chronic pain conditions. α-2 adrenergic agonists have both analgesic and sedative properties when used as adjuvant in regional anaesthesia. Aim: To study the effects of intrathecal dexmedetomidine added to ropivacaine for surgeries under spinal anesthesia. Materials and methods: This clinical study was conducted on 50 patients of ASA PS 1 and 2 in the age group of 18 -50 years of either sex posted for elective lower limb orthopaedic and lower abdominal surgeries under spinal anaesthesia after taking informed consent, study done over a period of 12 months. Results: All demographic details are insignificant. Average duration of surgery was 94.4 min ± 34.4 min. 76% (n= 38) of subjects belonged to ASA grade 1 and 34% (n=12) subjects belonged to ASA grade 2. Mean duration for onset of Sensory block was 4.12 minutes (SD: ± 1.69) and the mean duration for onset of motor block was 10.12 minutes (SD: ± 2.89). Pulse rate in all the patients was maintained in normal range during the observation period. Mean pulse rate was 76 ±4.3 beats per min. average mean systolic pressure was 117.7 ± 14.3 mm Hg and diastolic pressure 68.7± 4.6 mmHg. Tailam Tanmayee, P. Raghunath, D. Anuradha, R. Pandu Naik. Study of Dexmedetomidine as an intrathecal adjuvant to ropivacaine for postoperative analgesia. IAIM, 2017; 4(11): 241-249. Page 242 Mean values of SBP and DBP were maintained in the study population. However, when considered individually, Hypotension was observed in 3 patients after SAB (Fall in SBP > 20%). The hypotension was mainly observed after 4 to 6 min after SAB. The mean Ramsay sedation scale was 2.08 with SD 0.27. Side effects observed were mainly hypotension, nausea and shivering. Conclusion: To conclude, 5 microgram dexmedetomidine seems to be an attractive alternative as an adjuvant to spinal ropivacaine in surgical procedures, especially those requiring long time. This combination (ropivacaine and dexmedetomidine) provides very good quality of haemodynamic stability. It has excellent quality of postoperative analgesia with minimal side effects.
ABSTRACT
Background: Background & objectives :To study the effect of dexmeditomidine as an adjuvant to bupivacaine in brachial plexus block on onset and duration of sensory and motor block, duration of analgesia, level of sedation,perioperative hemodynamic parameters and complications. Methods: fourty patients of ASA Ι and ASA ΙΙ scheduled for upper limb surgery were included in double blind randomised comparison of inj. Dexmeditomidine and inj. Normal saline. We divided patients in two groups. Group A patients were given inj dexmeditomidine 50 microgm (0.5ml) and group B patients were given inj normal saline in brachial plexus block. We recorded time of onset and duration of sensory and motor block, level of sedation, duration of analgesia, hemodynamic changes and side effects in both groups. Results: mean time to onset of sensory block was 7.42±1.39 min in group A and 8.24± 1.35 min and that of motor block was 15.1± 2.6min in group A and 17.0± 2.9min in group B.Total duration of sensory block was 722.15±78.27min in group A and 360.62±61.7min in group B and that of motor block was 600.6± 54.46min in group A and 300.4± 54.26min in group B. Duration of analgesia was 970.36 ± 80.7 min in group A and 480±40.31 min in group B. Conclusion: addition of 50 microgm of inj dexmeditomidine to bupivacaine in brachial plexus block shortens onset and prolongs duration of sensory and motor block, prolongs duration of analgesia and decreases intraoperative requirement of sedatives.