Comparison of three different doses of Dexmedetomidine in subarachnoid block as an adjunct to Bupivacaine in lower limb orthopaedic surgery.

Dr. Kundan Sandugir Gosavi; Dr. Sachin Revansidh Swami

Volume : VIII, Issue : VII, July - 2018

Comparison of three different doses of Dexmedetomidine in subarachnoid block as an adjunct to Bupivacaine in lower limb orthopaedic surgery.

Dr. Kundan Sandugir Gosavi, Dr. Sachin Revansidh Swami

Abstract :

Dexmedetomidine is used to prolong the spinal subarachnoid block quiet often. However, the range of its dose is wide and varies from 3 mcg to 15 mcg. We compared three different doses of Dexmedetomidine to find out the optimum dose at which adequate prolongation of analgesia can be achieved without any adverse effect. Method: 120 ASA grade 1 patients of proposed lower limb orthopedic surgery were divided into four groups using randomization chart. All groups received 3.2ml 0.5% heavy bupivacaine for spinal SAB. For group D1: Dexmedetomidine 5μg, for group D2: Dexmedetomidine 10μg, for group D3: Dexmedetomidine 15 μg and for group B (control): 0.3 ml normal saline was added to Bupivacaine. Results: Onset of sensory blockade was significantly early in group D3 (mean 4.33±0.758) than D1 (mean 8.33±0.758) and control group (9.33±0.959) minutes. Motor block followed similar trend. Two segment regression of block was also significantly late in group D3 (mean 173.5± S.D. 12.875) compared to D2 (154±8.749min), D1 (137.5±5.686) and B (89.5±10.776) minutes. Mean total duration of analgesia in group D3 (313.17±21.515 min) was also significantly higher compared to D2 (276±10.86 min) and D1 (241.83±15.563 min) and control (188±8.57 min) groups. No significant differences were found in hemodynamic and respiratory parameters amongst all four groups. Incidence of adverse events was also comparable in all four groups. Conclusion: Dexmedetomidine prolongs the duration of sensory and motor block and overall duration of analgesia in dose dependant manner. 15 μgDexmedetomidine, the maximum dose used in our study has stable hemodynamic and respiratory profile.