Effects of IV dexmedetomidine as a pre-medication on clinical profile of bupivacaine spinal anaesthesia in lower abdominal surgeries- a randomized clinical study

Abstract

Introduction to evaluate the effects of intravenous (IV) dexmedetomidine as a pre-medication on clinical profile of bupivacaine spinal anaesthesia in lower abdominal surgeries. Methods this prospective randomized double blind study was done on 60 patients with ASA grade I/II undergoing lower abdominal surgeries under bupivacaine spinal anaesthesia. They were allocated to group-1 and group-2. Group-1 (control group) received normal saline and group-2 (study group) received IV dexmedetomidine 1 µg/kg over 10 min as premedication. Five minutes after premedication, subarachnoid block (SAB) was given with 3 ml of 0.5% hyperbaric bupivacaine following which sensory and motor blockade, hemodynamic changes, sedation, and complications of the surgery were recorded and this data was analyzed statistically using χ 2 test, corrected χ 2 test, Fisher´s exact test, and test of proportion (Z-test). Results the results of the present study showed that in group-2 there was significant decrease in the onset of sensory block, higher level of sensory blockade achieved, less time required to attain highest level of anaesthesia, prolonged time required for 2 dermatomal regression, prolonged duration of sensory blockade, prolonged duration of analgesia, decrease in onset of motor blockade, no significant increase in duration of motor blockade, there was overall hemodynamic stability except for few cases of bradycardia responding to atropine and hypotension responding to mephentramine, adequate and acceptable intraoperative sedation, and significantly less incidence of shivering in perioperative period. Conclusion IV infusion of dexmedetomidine 1 µg/kg body weight prior to SAB can be recommended to achieve better sensory blockade and adequate hemodynamic stability and sedation.

Comparison of the effect of dexmedetomidine and midazolam under spinal anesthesia for cesarean delivery: a randomized controlled trial, single center study in South Korea

“…Commonly used sedation agents include midazolam, ketamine, fentanyl, and propofol but the risks from these agents include, but are not limited to, apnea, hallucination, and impaired memory function [ 12 ]. Intravenous dexmedetomidine is commonly used for sedation in the nonpregnant patient population through a site in the locus coeruleus and dorsal raphe nucleus; it mimics natural sleep and produces analgesia [ 13 ]. Dexmedetomidine is a suitable adjuvant to spinal anesthesia due to its more selective α-2A receptor agonist activity and by acting at the spinal level, laminae VII and VIII of ventral horns.…”