TO STUDY THE DOSE RELATED EFFICACY OF INTRATHECAL DEXMEDETOMIDINE FOR PROLONGATION OF SPINAL ANAESTHESIA WHEN ADDED TO HYPERBARIC BUPIVACAINE IN COMPLEX LOWER LIMB ORTHOPEDIC SURGERIES

DR. SONALI HASTIR; DR. MARY SAMUEL

Volume : VIII, Issue : II, February - 2019

TO STUDY THE DOSE RELATED EFFICACY OF INTRATHECAL DEXMEDETOMIDINE FOR PROLONGATION OF SPINAL ANAESTHESIA WHEN ADDED TO HYPERBARIC BUPIVACAINE IN COMPLEX LOWER LIMB ORTHOPEDIC SURGERIES

Dr. Sonali Hastir, Dr. Mary Samuel

Abstract :

Spinal anaesthesia is the most commonly employed technique in surgeries below umbilicus. The commonly used local anaesthetic is hyperbaric bupivacaine, disadvantage of which is their short duration of action and early requirement of rescue analgesia post operatively. Alpha–2 agonists like clonidine have been proven to enhance the quality and duration of spinal anaesthesia. In this study we have used dexmedetomidine, higly selective alpha–2 agonist with a high ratio of alpha2/alpha1 activity .MATERIALS AND METHODS – Ninety patients randomized into three groups; each group containing thirty patients. The patient received 3.0 ml of hyperbaric bupivacaine plus either 0.5ml of 5 microgram dexmedetomidine (group D1) ,10 microgram dexmedetomidine (group D2) or 0.9% normal saline (group C). RESULTS – dexmedetomidine prolonged the time to two segment regression, motor regression to omage 0 and the time to rescue analgesic. All these effects were in the order D2 > D1 > C and statistically significant(p<0.005). All patients were hemodynamically stable. CONCLUSION – Intrathecal dexmedetomidine 5mcg and 10 mcg prolongs anesthetic and analgesic effects of hyperbaric bupivacaine and 10 mcg dose is more beneficial for prolonged surgeries.