Anti-Nociceptive, Analgesic and Pathohistological Effects of Intrathecal Dexmedetomidine and Bupivacaine in Rats

Erdivanlı, Başar; Altun, Murat; Sezen, Özlem; Çolakoğlu, Serhan

doi:10.1016/s0034-7094(13)70212-5

Cited by 13 publications

(3 citation statements)

References 20 publications

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“…DEX has been demonstrated to have significant analgesic effects ( 18–23 ). Although the mechanisms of the analgesic effect of DEX have not been fully elucidated, many studies have shown that DEX acted by inhibiting the release of substance P from the dorsal horn of the spinal cord ( 24,25 ). A recent study reported that DEX effected strong analgesia through inhibition of the spinal ERK1/2 signaling pathway ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine pretreatment alleviates propofol injection pain

et al. 2014

Upsala Journal of Medical Sciences

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ObjectiveThe incidence of propofol injection pain during induction of general anesthesia varies from 28% to 90%. This prospective, randomized, double-blind, placebo-controlled study evaluated the effect of dexmedetomidine (DEX) for reducing the incidence and severity of propofol injection pain.MethodsPatients undergoing elective surgical procedures were randomly allocated into seven groups of 30 patients each. Experimental treatments were intravenously administered over 10 min (total volume 10 mL) prior to intravenous propofol injection, as follows: group I, the control group, was given isotonic saline. Patients in groups II, III, and IV received DEX 0.25 µg/kg, 0.5 µg/kg, or 1.0 µg/kg, respectively, mixed with isotonic saline immediately before propofol injection. Patients in groups V, VI, and VII received DEX as above, but 5 minutes before propofol injection. Propofol consisted of 1% long-chain triglyceride propofol (2.5 mg/kg) injected at 1 mL/s.ResultsMedian propofol injection pain score was 0.00 (IQR 0.00–3.00) in patients who received 1.0 µg/kg DEX 5 min before the propofol injection (group VII), and only 1 patient (of 30) in this group received a pain score >2. The median pain score and number of patients with pain scores >2 in group VII were both significantly less than in the control (group I; p = 0.000, both). There were no differences in either mean arterial pressure or heart rate at any time point after DEX injection among the groups.ConclusionsPretreatment with intravenous DEX 1 µg/kg 5 min prior to injection of long-chain triglyceride propofol is effective and safe in reducing the incidence and severity of pain due to propofol injection.

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Section: Discussionmentioning

confidence: 99%

Dexmedetomidine pretreatment alleviates propofol injection pain

et al. 2014

Upsala Journal of Medical Sciences

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“…Furthermore, a study done in animals showed significant analgesic effect and increased duration of the sensory and motor block when intrathecal dexmedetomidine was given along with bupivacaine. 22 The sensory block prolongation by intrathecal dexmedetomidine was by depressing the C-fibre transmitter release and also by postsynaptic dorsal horn neurons hyperpolarization. 23 Intrathecal dexmedetomidine prolong motor block by binding to α2 adrenoreceptors of motor neurons located in the spinal cord dorsal horn.…”

Section: Discussionmentioning

confidence: 98%

Comparison of adjuvant effects of intrathecal magnesium sulfate and dexmedetomidine with hyperbaric bupivacaine

Sundararaju¹,

Poovathai²,

Batcha³

2021

IJCA

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Background: Surgeries involving infraumblical regions are commonly done under spinal anaesthesia. No single adjuvant to bupivacaine found to prolong the duration of analgesia and to reduce its limitations. Objectives: To compare the block characteristics of intrathecal administration of dexmedetomidine and magnesium sulfate as an adjuvant with bupivacaine in infraumblical surgeries. Materials and Methods: This is a prospective randomized double-blinded study. Around 90 American Society of Anaesthesiologist physical status I and II patients, scheduled for infraumblical surgeries were enrolled in this study. Patients were randomly assigned into Group B (bupivacaine), Group D (bupivacaine plus dexmedetomidine) and Group M (bupivacaine plus magnesium sulfate). In the operating theatre, baseline values were recorded. Onset and duration of sensory and motor block, time of rescue analgesia were noted. Results: The onset of sensory block was rapid in Group D (2.63 ± 0.66 min) and slow in Group M (6.35 ± 0.87 min) when compared to Group B (2.93 ± 0.785 min) with a statistically significant difference. Motor duration (min) was prolonged in Group D (423.00 ± 12.360) and early in the Group M (165 ± 31.55) when compared to Group B (219.23 ± 14.875). Conclusion: For the surgery, which requires prompt onset and long duration of analgesia,dexmedetomidine can be used as an adjuvant. However, surgical procedures that permit delayed onset block and shorter duration of analgesia,magnesium sulfate can be preferred.

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“…The analgesic effect of Dex-could be achieved with a high dose of 1 ug/kg over 10 min (26); however, to avoid anesthetic complications, our study used just 0.5 ug/kg of Dex-pre-anesthesia, and its effect on pain relief possibly originates from its sedation property. Current evidence suggests that Dex-acts by inhibiting the release of substance P from the dorsal horn of the spinal cord and the spinal ERK1/2 signaling pathway (27)(28)(29). A study by Park et al demonstrated that Dex-exerted a dose-dependent analgesic effect in rat models.…”

Section: Discussionmentioning

confidence: 99%

Intravenous Dexmedetomidine Administration Prior Anesthesia Induction With Propofol at 4°C Attenuates Propofol Injection Pain: A Double-Blind, Randomized, Placebo-Controlled Trial

Liu³

et al. 2021

Front. Med.

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Background: Propofol injection pain, despite various interventions, still occurs during the anesthesia induction and causes intense discomfort and anxiety in patients. This study aimed to explore the effect of intravenous dexmedetomidine on propofol injection pain prior to anesthesia induction with propofol at 4°C.Methods: A total of 251 patients (American Society of Anesthesiologists I–II) who underwent oral and maxillofacial surgery were randomly assigned to a combination group (n = 63), lidocaine group (n = 62), dexmedetomidine group (n = 63), and placebo-control group (n = 63); they received 0.5 ug/kg dexmedetomidine prior to anesthesia induction with propofol at 4°C, 40 mg lidocaine, 0.5 ug/kg dexmedetomidine prior to anesthesia induction, and normal saline, respectively. Incidence of pain, pain intensity, and reaction to the pain stimulus were evaluated by using verbal categorial scoring (VCS), a numerical rating scale (NRS), and the Surgical Pleth Index (SPI), respectively. In addition, hemodynamic parameters such as heart rate (HR) and mean arterial pressure (MAP) were also measured. The VCS and NRS were evaluated at 5 s after propofol injection. In addition, SPI, HR, and MAP were evaluated at three time points (before anesthesia induction and 5 and 30 s after propofol injection).Results: The incidence of pain in the combination group (51%) was significantly lower than that in the lidocaine group (71%), dexmedetomidine group (67%), or placebo-control group (94%) (p < 0.001). VCS and NRS scores in the combination group were also lower compared with the other three groups (p < 0.001), with no statistically significant differences between the lidocaine group and dexmedetomidine group (p > 0.05). The SPI of the combination group decreased significantly in comparison with the other three groups at 5 s after propofol injection (F = 96.23, p < 0.001) and 30 s after propofol injection (F = 4.46, p = 0.005). Further comparisons between HR and MAP revealed no significant differences across the groups (p > 0.05).Conclusion: Because of the sedative nature of dexmedetomidine and analgesic effect of low temperature, this study showed that intravenous dexmedetomidine prior to anesthesia induction with propofol at 4°C is highly effective in attenuating the incidence and severity of pain during injection compared with lidocaine (40 mg), dexmedetomidine 0.5 ug/kg) and placebo. This approach was not associated with any anesthesia complications.Clinical Trial Registration:ClinicalTrials.gov, identifier: ChiCTR-2000034663

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Anti-Nociceptive, Analgesic and Pathohistological Effects of Intrathecal Dexmedetomidine and Bupivacaine in Rats

Abstract: There were no apparent pathohistological changes at least 24 hours after the intrathecal administration of a single dose of dexmedetomidine 3 μg and 10 μg. Dexmedetomidine added to bupivacaine for spinal block improves analgesia and prolongs block duration.

Cited by 13 publications

References 20 publications

Dexmedetomidine pretreatment alleviates propofol injection pain

Dexmedetomidine pretreatment alleviates propofol injection pain

Comparison of adjuvant effects of intrathecal magnesium sulfate and dexmedetomidine with hyperbaric bupivacaine

Intravenous Dexmedetomidine Administration Prior Anesthesia Induction With Propofol at 4°C Attenuates Propofol Injection Pain: A Double-Blind, Randomized, Placebo-Controlled Trial

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