COMPARISON OF INTRATHECAL DEXMEDETOMIDINE AND INTRATHECAL BUPRENORPHINE AS AN ADJUVANT TO BUPIVACAINE FOR SPINAL ANAESTHESIA IN LOWER ABDOMINAL SURGERIES.

DR.K.ANITHA; DR.P.S.ARUNA LATHA

Volume : VIII, Issue : VIII, August - 2019

COMPARISON OF INTRATHECAL DEXMEDETOMIDINE AND INTRATHECAL BUPRENORPHINE AS AN ADJUVANT TO BUPIVACAINE FOR SPINAL ANAESTHESIA IN LOWER ABDOMINAL SURGERIES.

Dr. K. Anitha, Dr. P. S. Aruna Latha

Abstract :

BACKGROUND: Spinal anaesthesia is one of the most suitable modality of anaesthesia for lower abdominal surgeries. In recent years, the supplementation of local anaesthetics with adjuvants is widely in practice, to reduce the dose of local anaesthetic, minimize side effects and prolong the duration of anaesthesia. This study was designed to evaluate characteristics of the spinal block achieved with the use of adjuvants, dexmedetomidine and buprenorphine with bupivacaine, in terms of achievement and maintenance of block, haemodynamics, post–operative analgesia & adverse effects. METHODS: This clinical study was conducted on 90 ASA physical grade 1 & 2 patients of either sex, in the age group of 18 years to 60 years, scheduled for elective lower abdominal surgeries under spinal anaesthesia at GGH, KURNOOL MEDICAL COLLEGE, KURNOOL from the period of 2016 May–2017 August. Patients were randomly divided on an alternative basis into three groups of 30 each. Group–A: Patients received 3ml of 0.5% hyperbaric Bupivacaine with 0.5ml normal saline intrathecally. Group–B: Patients received 3ml of 0.5% hyperbaric bupivacaine with 60μg of buprenorphine intrathecally. Group–D : Patients received 3ml of 0.5% hyperbaric Bupivacaine with 5μg dexmedetomidine intrathecally. .RESULTS: The characteristics of subarachnoid block between the three groups were comparable in terms of age, sex, weight and height.Buprenorphine group has early onset of motor block compared to Dexmedetomidine and control group.The time for two segmental regression was higher and statistically significant in Buprenorphine when compared with dexmedetomidine and control. Duration of analgesia in Dexmedetomidine group was significantly prolonged when compared with groups B and A, and Buprenorphine group has prolonged duration of analgesia compared to control group and it is statistically significant. CONCLUSION: The present study demonstrated that addition of 5μg dexmedetomidine to bupivacaine in patients undergoing lower abdominal surgeries compared to 60μg buprenorphine provided a longer duration of sensory and motor block, with relative haemodynamic stability