Comparison of block characteristics of spinal anesthesia following intravenous dexmedetomidine and clonidine

Agrawal, Akansha; Agrawal, Sanjay; Payal, Yashwant Singh

doi:10.4103/0970-9185.188830

Cited by 22 publications

(24 citation statements)

References 26 publications

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“…As a result, the initiation of surgery was faster, and it was easier to administer sufficient anesthesia. In a similar study, Agrawal et al [25] demonstrated that IV dexmedetomidine prolonged the duration of blockade in patients administered spinal anesthesia.…”

Section: Discussionmentioning

confidence: 89%

Effects of dexmedetomidine infusion during spinal anesthesia on hemodynamics and sedation

Kılıç

Aydin²

2018

Libyan Journal of Medicine

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Background: We evaluated the effects of intravenous dexmedetomidine during spinal anesthesia on hemodynamics, respiratory rate, oxygen saturation, sedpain, and compared them with those of saline infusion. Sixty American Society of Anesthesiologists physical status I and II cases were randomly divided into two groups. Patients were connected to the monitor after premedication, and spinal anesthesia was administered. Sensory and motor blockades were assessed using pinprick test and Bromage scale, respectively. Group I received dexmedetomidine infusion and Group II received saline infusion. Throughout the infusion process, hemodynamic data, respiratory rate, oxygen saturation, sedation, pain, Bromage score, amnesia, bispectral index, and side effects were recorded. Postoperative hemodynamic measurements, oxygen saturation, sedation, pain scores were obtained. Sedation and pain were evaluated using the Ramsay and visual analog scales, respectively. Analgesics were administered in cases with high scores on the visual analog scale. Postoperative analgesic consumption, side effects, treatments were recorded. No significant differences were found between the groups with respect to oxygen saturation, respiratory rate, pain, and side effects in the intraoperative period. Time to onset of sensorial block, maximum sensorial block, onset of motor block, and maximum motor block; bispectral index values; and apex heartbeat until 80 min of infusion, systolic arterial blood pressure until 90 min, and diastolic arterial blood pressure until 50 min were lower, whereas amnesia and sedation levels were higher in dexmedetomidine group. Postoperative pain and analgesic requirement were not different. Apex heartbeat at 15 min and systolic arterial blood pressure at 30 min were lower and sedation scores were higher in the dexmedetomidine infusion group. We demonstrated dexmedetomidine infusion had a hemodynamic depressant effect intraoperatively whereas it had no significant effect on peripheral oxygen saturation, respiratory rate, visual analog scale scores, and side effects. Dexmedetomidine infusion enhanced motor and sensory blockade quality and induced amnesia and sedation.

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Section: Discussionmentioning

confidence: 89%

Effects of dexmedetomidine infusion during spinal anesthesia on hemodynamics and sedation

Kılıç

Aydin²

2018

Libyan Journal of Medicine

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“…Patients who received SC dexmedetomidine or clonidine as adjuvants to SAB required significantly less analgesia in the postoperative period in contrast to patients who received SAB alone. Agarwal et al3 compared IV dexmedetomidine infusion versus IV clonidine infusion as adjuvant to SAB. They found that patients who received either of the two drugs intraoperatively required significantly lower doses of rescue analgesic agents in the postoperative period when compared to the control group.…”

Section: Discussionmentioning

confidence: 99%

“…Alpha 2 adrenergic agonists have both analgesic and sedative properties when used as adjuvants to SAB. They act at spinal and supra spinal levels of the central nervous system (CNS) to modulate pain relief 3…”

Section: Introductionmentioning

confidence: 99%

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<p>Comparison of subcutaneous dexmedetomidine versus clonidine as an adjuvant to spinal anestheia: a randomized double blind control trial</p>

Srinivas¹,

Lakshminarasimhaiah

2019

LRA

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Background: Alpha-2 adrenergic agonists like clonidine and dexmedetomidine prolong the duration of postoperative analgesia and improve the quality of subarachnoid block (SAB) when used as adjuvant in various routes. However, addition of these drugs by IV or intrathecal routes are known to cause hemodynamic instability. The subcutaneous (SC) route provides similar efficacy as IV administration with less hemodynamic instability and prolonged effect. Aims : To compare the efficacy of clonidine and dexmedetomidine as adjuvants to SAB when used subcutaneously. Materials and methods: A total of 90 patients were randomized into one of the three groups: Group P received 1 ml of Normal saline SC, Group D received 0.5 mcg/kg of dexmeditomedine SC and Group C received 1 mcg/kg of clonidine SC respectively after SAB with 3ml of 0.5% hyperbaric bupivacaine (15 mg). Time of onset of sensory and motor block, intraoperative hemodynamics, postoperative VAS scores, Richmond agitation sedation scale, duration of postoperative analgesia and mean paracetamol requirement in 24 hours were recorded. Results: Mean duration of postoperative analgesia was prolonged in group D (838.10±348.22 minutes) and group C (816.67±230.48 minutes) when compared to group P (332.10±110.91 minutes). Total paracetamol consumption was less in group D (1400.00±770.13 mg) and group C (1600.00±674.66 mg), whereas it was 1900.00±758.86 mg in group P. Hemodynamic parameters, maximum sensory level attained, and time to attain maximum sensory levels were comparable among the two groups. Conclusion: Both subcutaneous clonidine and dexmedetomidine prolonged the duration of postoperative analgesia and reduced analgesic requirements when used as adjuvants to SAB with stable hemodynamics, hence both of these drugs can be used effectively as adjuvants to SAB.

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“…The length of postoperative anaesthesia was longer in Dexmedetomidine group. They arrived at the conclusion that better conditions were achieved as a result of using Dexmedetomidine [ 15 ]. In the present research, Fentanyl yielded a longer period of anaesthesia with less drug needed after the operation.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Dexmedetomidine and Fentanyl as an Adjuvant to Lidocaine 5% for Spinal Anesthesia in Women Candidate for Elective Caesarean

Kamali¹,

Azadfar²,

Pazuki³

et al. 2018

Open Access Maced J Med Sci

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AIM:This study aimed to compare the effect of Dexmedetomidine and fentanyl as an adjuvant to lidocaine 5% in spinal anaesthesia to increase post-operative analgesia among women candidates for elective caesarean.METHODS:Eighty-four pregnant women candidates for caesarian were randomly divided into fentanyl and Dexmedetomidine groups. In the first group, 25 μg fentanyl was added to lidocaine 5% while in the second group, 0.5 μg per kilogram Dexmedetomidine was added to lidocaine 5%. After the operation, a pain score of the patients in recovery and within 4, 12 and 24 hours after the operation, the average length of analgesia and the average amount of the analgesics taken within 24 hours and after the operation were recorded.RESULTS:The average length of postoperative anaesthesia and the average amount of the drug taken within the first 24 hours after the operation in fentanyl group was more than the Dexmedetomidine group (P = 0.01). Shivering in Dexmedetomidine group was more common than what was observed in the fentanyl group (P = 0.001). Higher rates of nausea-vomiting were observed in the fentanyl group (P = 0.001).CONCLUSIONS:Fentanyl results in a longer period of postoperative analgesia and less consumption of drugs after the operation. Fentanyl is recommended in caesarian.

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Comparison of block characteristics of spinal anesthesia following intravenous dexmedetomidine and clonidine

Cited by 22 publications

References 26 publications

Effects of dexmedetomidine infusion during spinal anesthesia on hemodynamics and sedation

Effects of dexmedetomidine infusion during spinal anesthesia on hemodynamics and sedation

<p>Comparison of subcutaneous dexmedetomidine versus clonidine as an adjuvant to spinal anestheia: a randomized double blind control trial</p>

Comparison of Dexmedetomidine and Fentanyl as an Adjuvant to Lidocaine 5% for Spinal Anesthesia in Women Candidate for Elective Caesarean

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