Effect of low‐dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block

Abstract

Background: The purpose of this study was to compare the onset and duration of sensory and motor block, as well as the hemodynamic changes and level of sedation, following intrathecal bupivacaine supplemented with either dexmedetomidine or clonidine. Methods: In a prospective, double-blind study, 60 patients undergoing transurethral resection of prostate or bladder tumor under spinal anesthesia were randomly allocated to one of three groups. Group B received 12 mg of hyperbaric bupivacaine, group D received 12 mg of bupivacaine supplemented with 3 mg of dexmedetomidine and group C received 12 mg of bupivacaine supplemented with 30 mg of clonidine. The onset times to reach peak sensory and motor levels, and the sensory and motor regression times, were recorded. Hemodynamic changes and the level of sedation were also recorded. Results: Patients in groups D and C had a significantly shorter onset time of motor block and significantly longer sensory and motor regression times than patients in group B. The mean time of sensory regression to the S1 segment was 303 AE 75 min in group D, 272 AE 38 min in group C and 190 AE 48 min in group B

Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia

“…[1][2][3] Also, it has been used safely as premedication or as a sedative agent in patients undergoing surgical procedures under regional anesthesia. 4,5 Although a synergistic interaction between intrathecal dexmedetomidine and local anesthetics has been observed in previous studies, [6][7][8][9] there are no clinical data regarding the effect of intravenous dexmedetomidine premedication on the duration of sensory and motor block during spinal anesthesia.…”

Effect of dexmedetomidine on the characteristics of bupivacaine in a caudal block in pediatrics

“…16 OPS, sedation, and behavior scores in the recovery room were recorded by the same nurse at 60-min intervals. Once in the ward, only the OPS, and sedation scores were documented at 6,8,10,12,16,20, and 24 h post-operatively. Time to first analgesic dose (time between caudal injection and first administration of rescue analgesic), the total consumption of analgesic in the first 24 h and quality of sleep were recorded.…”

“…Intrathecal DEX was reported to produce analgesia in experimental animals, 9 prolong the duration of spinal bupivacaine 10 and potentiate the effect of spinal morphine in cancer pain in humans. 11 Few reports have described the use of epidural DEX in the management of acute post-operative pain in adults.…”

Effect of Different Doses of Dexmedetomidine as Adjuvant in Bupivacaine -Induced Subarachnoid Block for Traumatized Lower Limb Orthopaedic Surgery: A Prospective, Double-Blinded and Randomized Controlled Study

“…Dexmedetomidine is still under evaluation as an ideal neuraxial adjuvant as it provides stable hemodynamic conditions, good quality of intraoperative and prolonged postoperative analgesia with minimal side effects [16][17][18]. Kanazi et al, demonstrated a significant prolongation in the duration of sensory and motor block with dexmedetomidine used as intrathecal additive for 0.5% heavy bupivacaine [16].…”

“…Kanazi et al, demonstrated a significant prolongation in the duration of sensory and motor block with dexmedetomidine used as intrathecal additive for 0.5% heavy bupivacaine [16].…”