Efficacy of dexmedetomidine infusion for procedural comfort and intraoperative sedation in patients undergoing surgeries with subarachnoid block: A randomized double-blind clinical trial

Abstract

Introduction:There is increasing evidence to include sedation as an integral part of regional anesthesia to ensure patient comfort. This may compromise patient cooperation, an important component of regional anesthesia. We decided to determine the efficacy of dexmedetomidine (0.3 μg/kg/h and 0.5 μg/kg/h) for allaying procedural discomfort and ensuring their cooperation in patients undergoing surgery with subarachnoid block.Setting:Tertiary care center.Materials and Methods:Sixty patients with the American Society of Anesthesiologists physical status Class I and II posted for surgeries under subarachnoid block were randomized into two groups of 30 each to receive dexmedetomidine in a loading dose of 1 μg/kg in both groups followed by continuous infusion of 0.3 μg/kg/h in Group D 0.3 and 0.5 μg/kg/h in Group D 0.5. Observer assessment sedation score, ease of positioning score, response to spinal needle insertion, hemodynamic parameters, patient satisfaction (PS) score, and surgeon satisfaction (SS) score were evaluated.Results:Median observer Assessment Sedation Score ranged between four and three at all times during dexmedetomidine infusion in Group D 0.3. In Group D 0.5, median Observer assessment of alertness/sedation scale ranged between three and two. Ease of positioning (P = 1.000) and response to spinal needle insertion (P = 0.521) were comparable in both groups. PS was higher in Group D 0.5 as compared to Group D 0.3. SS score was comparable in both the groups.Conclusion:Intravenous dexmedetomidine infusion 0.3 μg/kg/h produces effective sedation in patients undergoing surgery with spinal anesthesia while ensuring patient cooperation for positioning and without any recall of the procedure in postoperative period.

Dexmedetomidine as an adjuvant for single spinal anesthesia in patients undergoing cesarean section: a system review and meta-analysis

“…Recently, dexmedetomidine has been commonly applied as an assistant drug for a subarachnoid block during the perioperative period. [37][38][39] A previous meta-analysis by Liu et al 15 considered that the addition of dexmedetomidine could significantly reduce the onset time of spinal anesthesia. However, two trials 14,20 in that metaanalysis did not meet the inclusion criteria because of the combined spinal and epidural anesthesia.…”

“…Recently, dexmedetomidine has been commonly applied as an assistant drug for a subarachnoid block during the perioperative period. 37–39 A previous meta-analysis by Liu et al. 15 considered that the addition of dexmedetomidine could significantly reduce the onset time of spinal anesthesia.…”

Comparison of sciatic nerve block quality achieved using the anterior and posterior approaches: a randomised trial

“…Patient satisfaction was scored as 0: failed, 1: weak, 2: moderate, 3: good, and 4: excellent [11, 12]. Anaesthesia quality (anaesthesiologist) was scored as follows: 1: general anaesthesia was required, 2: complementary analgesic was needed, moderate complaints, 3: no need for complementary analgesia, few complaints, and 4: no complaints [11].…”