Comparative study between the effect of intrathecal bupivacaine versus bupivacaine dexmedetomidine combination in spinal anaeshtesia for lower abdominal surgeries

Abstract

Study objectives We compared effect of intrathecal bupivacaine versus bupivacaine Design This is a prospective, randomized, double-blinded study. Setting The setting is at an operating room in Ain Shams University Hospital. Patients: 50 patients scheduled for general anesthesia were randomly allocated to the following 2 groups in equal numbers. Interventions Spinal anaesthesia will be performed in the sitting position at L3-L4 or L4-L5 level using a 25-gauge Quincke spinal needle by the most competent experts. The sensory block level will be assessed along the mid-clavicular line bilaterally. The motor block will be assessed according to Bromage scale Measurements Post operative (VAS) score and Time to first requested analgesia.(primary outcome), Systolic blood pressure, diastolic blood pressure, mean blood pressure and heart rate will be recorded every 5 minutes for 20 minutes then every 15 minutes till the end of surgery, Nausea and/ or vomiting as yes/no, Level of highest sensory block, Bromage score ≥3, Onset of sensory block and Two segment regression time (secondary outcomes) were recorded.. Main results Results of this study showed that the addition of dexmedetomidine to bupivacaine in spinal anaesthesia significantly prolonged both sensory and motor blockades duration compared with bupivacaine alone. They also prolonged the time of postoperative analgesia as evidenced by significantly longer time to first rescue analgesia and lower NRS scores with minimal adverse effects and haemodynamic stability. Conclusions We concluded that intrathecal dexmedetomidine increases the duration of analgesia and reduces postoperative pain without changes in the hemodynamic parameters and adverse side effects. It can be considered as an appropriate adjuvant to intrathecal local anesthetics for lower abdominal surgeries.