A COMPARATIVE STUDY BETWEEN 0.5% LEVOBUPIVACAINE WITH DEXMEDETOMIDINE AND 0.5% BUPIVACAINE WITH DEXMEDETOMIDINE IN SUBARACHNOID BLOCK

Dr. P. V. Phaneendra Babu; Dr. B. Durga Venkatram; Dr. G. Bhagyalakshmi; Dr. K. Vasudha

Volume : VIII, Issue : VI, June - 2019

A COMPARATIVE STUDY BETWEEN 0.5% LEVOBUPIVACAINE WITH DEXMEDETOMIDINE AND 0.5% BUPIVACAINE WITH DEXMEDETOMIDINE IN SUBARACHNOID BLOCK

Dr. P. V. Phaneendra Babu, Dr. B. Durga Venkatram, Dr. G. Bhagyalakshmi, Dr. K. Vasudha

Abstract :

Introduction: Spinal anaesthesia provides profound muscular relaxation and analgesia which is ideal for intra–abdominal and orthopedic procedures. Bupivacaine has been one of the most common local anaesthetic agent used for subarachnoid block. The levo– enantiomer of bupivacaine is found to be less toxic compared to dextroisomer and racemic mixture. Dexmedetomidine which is an alpha–2 agonist is now being used as an adjuvant to hyperbaric bupivacaine to produce analgesia that is faster, more intense with prolonged sensory & motor blockade. Materials and Method: A prospective randomized clinical trial was conducted at ALLURI SITARAMA RAJU ACADEMY OF MEDICAL SCIENCES, ELURU on 60 patients scheduled for elective lower abdominal, urologic and lower limb surgeries between 2017–2019.the patients are randomly divided into 2 groups. Group A received 0.5% isobariclevobupivacaine (15mg) with dexmedetomidine (5 μg) and Group B received0.5% hyperbaric bupivacaine (15mg) with Dexmedetomidine (5μg) in sub–arachnoid block. Sensory block assessed by loss of sensations by pinprick method. Motor blockade assessed by using omage scale. Pain was evaluated by visual analogue scale. Results: It was observed that the time of onset of sensory blockade was significantly shorter in Group B compared to Group A.The time taken to reach grade4 motor blockade was shorter with Group B compared to Group A. There was no significant difference between both the groups in relation to time for rescue analgesia and hemodynamic variations. Conclusion: we conclude that 0.5% Isobaric Levobupivacaine with dexmedetomidine is a safer alternative to 0.5% hyperbaric racemic bupivacaine with dexmedetomidine for subarachnoid block.