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

Dr. Vathsalya Jillella, Dr. Manirekha. P

Abstract


Background: Various adjuvants have been used with local anesthetics in spinal anesthesia to avoid intraoperative visceral and somatic pain and to provide prolonged postoperative analgesia. Dexmedetomidine, the new highly selective α2-agonist drug, is now being used as a neuraxial adjuvant. Buprenorphine is a centrally acting lipid soluble analogue of alkaloid thebaine. It exhibits analgesic property both at spinal and supraspinal levels.6The aim of the study was to compare onset of sensory and motor block, duration of complete analgesia, time for two segmental regression of sensory block, time for complete recovery of motor block, hemodynamic effects and side effects due to intrathecal buprenorphine, dexmedetomidine with hyperbaric 0.5% bupivacaine. Materials & Method:  90 ASA I and II patients of either sex, scheduled for elective lower abdominal surgeries under spinal anesthesia were randomly allocated to receive either 3ml of 0.5% hyperbaric bupivacaine with 0.5ml Normal saline (group A, n=30) or 3ml of 0.5% hyperbaric bupivacaine with 60µg Buprenorphine (group B, n=30) or 3ml of 0.5% hyperbaric bupivacaine with 5µg of Dexmedetomidine (group D, n=30) intrathecal. Results: Patients in dexmedetomidine group (D) had a significantly longer duration of complete analgesia, motor block and time for two segment regression. The onset of motor blockade is faster with patients in Buprenorphine group (B). Nausea and vomiting (20%) was observed significantly more in group B (p>0.05). Conclusion: Use of Intrathecal Dexmedetomidine is an excellent additive to Bupivacaine for quality of anesthesia and prolonged duration of analgesia without any deleterious effects

Keywords


Dexmedetomidine, Bupivacaine, Spinal Anesthesia

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