Randomized Controlled Trial to Evaluate the Efficacy of Intrathecal Dexmedetomidine to Low dose hyperbaric 0.5% Bupivacaine in Elective Lower Segment Caesarean Section

Abstract

Abstract Introduction: Dexmedetomidine has been safely used as an adjuvant for subarachnoid block in obstetric as well as non-obstetric surgeries and was found to be effective without adverse effects. Hence, this study was conducted to determine the efficacy of intrathecal Dexmedetomidine for elective lower segment caesarean sections with reduction of local anesthetic dose. Objectives: This double blinded, randomized controlled study was designed to compare the effects of addition of Dexmedetomidine on 1) Sensory and motor block 2) Maternal hemodynamics 3) Post-operative analgesia and 4) Neonatal outcome. Methods: Eighty parturients were enrolled in study and randomized into two groups as of 40 each and named as Group D and Group B. Group D received 0.5% Hyperbaric Bupivacaine 9mg (1.8ml) + Dexmedetomidine 5µg (0.2ml of 25 µg per ml ) and for Group B received 0.5% Hyperbaric Bupivacaine 10mg (2ml) . Characteristics of block, maternal hemodynamics and neonatal outcome were recorded. P value <0.05 was considered as significant. Results: Sensory onset was rapid in D group as compared to B group (3.7 ± 1.1vs 4.5±1.2) and motor onset was also rapid in D group (3.8±2.0 vs 4.9 ±1.9) with 95% CI. Duration of analgesia was also significantly high in Group D (230.5±40.5 vs 145.1±28.5). No adverse maternal and fetal outcomes were reported. Conclusion: Intrathecal Dexmedetomidine with low dose bupivacaine for cesarean section hastens the sensory as well as motor onset without adversely affecting mother and neonate.