COMPARATIVE STUDY OF EFFECTS OF TWO DIFFERENT DOSES OF INTRAVENOUS DEXMEDETOMIDINE IN SPINE SURGERIES

Dr. Vasanti Kelkar; Dr. Radhika S Ruhatiya; Dr. Prabha Nayak

Volume : VII, Issue : I, January - 2017

COMPARATIVE STUDY OF EFFECTS OF TWO DIFFERENT DOSES OF INTRAVENOUS DEXMEDETOMIDINE IN SPINE SURGERIES

Dr. Vasanti Kelkar, Dr. Radhika S Ruhatiya, Dr. Prabha Nayak

Abstract :

Background:

Present study was conducted to compare effectiveness of two doses of Dexmedetomidine to find the minimum dose of the drug required to achieve stable haemodynamic parameters with least side effects in spine surgery.

Material and methods:

In this prospective randomized double blind study, two groups of 40 patients each received Dexmedetomidine intravenously. After bolus of 1 µg/kg over 10 minutes, Group A received Dexmedetomidine 0.4µg/kg/hr and Group B 0.2µg/kg/hr as maintenance infusion. Intra–operative monitoring of pulse rate, blood pressure, ECG and oxygen saturation was done. Extubation response, modified Aldrete’s score, duration of extubation response, time to extubation and surgeon’s satisfaction using bleeding score was noted . Data was analyzed using students’t–test & chi square test.

Results:

Demographic parameters were comparable in both the groups. Heart rate and blood pressure in both the groups were comparable at all times. The duration of extubation response was less in group A (3.28±0.89 min) than Group B (4.23±1.30 min; p=0.000). The difference in mean extubation time (min) in both the groups was statistically insignificant. (Group A: 19.62±6.44; Group B: 17.52±6.42; p=0.149). Modified Aldrete’s score at 10th minute post–extubation showed earlier recovery in Group B (9.55±0.51) than Group A (8.42±0.50; p=0.001). Incidence of adverse cardiovascular events was low and comparable in both the groups. Quality of operative field was comparable in both the groups (bleeding score 2– in 85% and 82.5% patients, score 1 – 15% and 17.5% patients respectively, p = 0.762)

Conclusion:

In spine surgery, dexmedetomidine when used as adjuvant to general anaesthesia in the dose of 0.2µg/kg/hr or 0.4µg/kg/hr provides intra–operative haemodynamic stability and improves quality of operative field with minimal side effects although dexmedetomidine 0.2µg/kg/hr provides earlier recovery than dexmedetomidine 0.4µg/kg/hr.