STUDY OF THE EFFECTS OF INTRAVENOUSDEXMEDETOMIDINE ON SPINAL ANAESTHESIA ANDANALGESIA IN PATIENTS UNDERGOING LOWER ABDOMINAL SURGERIES AT NMC, SASARAM, BIHAR

Dr. Alok Kumar, Dr. Prof. Subrato Naag, Dr. Debarshi Jana

Abstract


BACKGROUND AND OBJECTIVE : Spinal anaesthesia is a well known technique used in lower abdominalsurgeries. Dexmedetomidine is a
highly selective and potent alpha 2 agonist. Thepresent study was aimed to assess the effects of intravenous dexmedetomidinepremedication on
spinal anaesthesia and analgesia with 0.5% HyperbaricBupivacaine.
METHODS : This one year double blind randomized placebo controlled trial wasconducted in the Department of Anaesthesia, Narayan Medical
College, Jamuhar,Sasaram,Bihar. A total of 60 patients undergoing lower abdominalsurgeries were allocated into two groups namely, Group D
(n=30; patientsreceived dexmedetomidine 0.1 mL/Kg [0.5 μg/kg] over 15 minutes using infusionpump 20 minutes prior to SAB) or Group P
(n=30; Patients received 0.1 mL/kgnormal saline over 15 minutes using infusion pump 20 minutes prior to SAB).
RESULTS :In this study, male to female ratio was 0.46:1. Both the groups werecomparable with respect to sex, age, height and weight. No biphasic
change inheart rate or mean arterial pressure or significant cardiovascular variability wasobserved after administration of dexmedetomidine.
Arterial oxygen saturation inboth groups remained above 97% throughout the study and was comparable inboth groups. The requirement of
Atropine and Ephedrine was found to becomparable in both groups. Patients in dexmedetomidine group had asignificantly higher level of highest
sensory block level (T4.8±1.52). MotorBlock duration was significantly prolonged in group D (128.00±20.07). SensoryBlock duration in
dexmedetomidine group (165.67±19.77) was significantlylonger.
CONCLUSION AND INTERPRETATION : Overall, based on the findings of this study it may be concluded that,single dose of intravenous
dexmedetomidine given as premedication, prolongsthe duration of sensory and motor blockade of bupivacaine-induced spinalanaesthesia. It also
provides conscious sedation and additional analgesia,maintaining haemodynamic stability.


Keywords


Dexmedetomidine; Hyperbaric Bupivacaine; Motor Block; Sedation;sensory Block; Spinal Anaesthesia.

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