Effect of intravenous and epidural dexmedetomidine on spinal block in lower limb and lower abdominal surgeries. A comparative study

Dr. Mrinal Kanti DebBarma; Dr. Ashem Jack Meitei; Dr. Pradipkumar Singh L; Dr. Mithun Raj R; Dr. Ch. Rabindra Singh

Volume : VI, Issue : IV, April - 2017

Effect of intravenous and epidural dexmedetomidine on spinal block in lower limb and lower abdominal surgeries. A comparative study

Dr. Mrinal Kanti Debbarma, Dr. Ashem Jack Meitei, Dr. Pradipkumar Singh L, Dr. Mithun Raj R, Dr. Ch. Rabindra Singh

Abstract :

Background: Dexmedetomidine, a selective α2 agonist with sedative and analgesic properties has been used to prolong duration of analgesia. Aim: The present study was designed to see the effect of dexmedetomidine 0.5cmg/kg of body weight given epidurally produces longer analgesia and sedation than given intravenously on hyperbaric bupivacaine spinal anaesthesia. Materials and Methods: Hundred patients undergoing lower abdomen or lower limb surgeries under spinal anaesthesia were selected and randomly divided into group I and group E. Immediately following spinal anesthesia, both the groups received bolus dexmedetomidine 0.5�g/kg over ten minutes followed by infusion of 0.5mcg/kg/hr through the respective allocated route of administration for the duration of surgery (i.e. Group I: i.v and group E: epidural). Time for the onset of sensory and motor block, time of loss of pain to pin prick sensation up to T10, time of sensory regression by 2 segments and duration of analgesia were recorded. Sedation scores by Ramsay Sedation Score (RSS) and haemodynamic parameters were assessed. Results: Time of sensory regression by two segments was significantly prolonged in the epidural group than intravenous group (257.06�15.60 min vs 184.90�22.46 min), P<0.001. Sedation for intravenous group was higher than epidural group and was statistically significant from 15 minutes onwards (P<0.05). Postoperative analgesia was significantly prolonged in epidural group (335.30�47.62 min vs 223.5�28.93 min) than intravenous group, P<0.001. Conclusion: Epidural infusion of dexmedetomidine prolonged the duration of post operative analgesia compared to intravenous infusion with equal dose. But easily arousible sedative effect was higher in intravenous group.