Dexmedetomidine infusion on subarachnoid block with bupivacaine in inguinal herniorrhaphies - A prospective study

Savala Chaitanya
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Abstract

Background: Dexmedetomidine (D) is alpha-2 agonist that acts as an anaesthetic and analgesic substitute. The goal of this study was to see how intravenous (I.V.) dexmedetomidine affected the length of sensory and motor block, postoperative analgesia, sedation degree, and side effects. Aims: To assess the effect of Dexmedetomidine infusion on the duration of analgesia with spinal Bupivacaine for adult patients undergoing herniorrhaphy and to assess side effects. Materials and methods: Prospective study was done under the for a period of 11 months. In 80 adults aged 20 to 60 years scheduled for herniorrhaphies were allocated into two study groups, named B and BD using computer generated randomization. The enrolled patients were divided into 2 groups each 40 patients to receive either 0.5 µg/kg dexmedetomidine intravenous bolus over 10 min (Group BD) or saline infusion (Group B) prior to subarachnoid block with 0.5% hyperbaric bupivacaine 12.5 mg Results: Numerical pain rating scale scores were significantly lower in group BD. Total analgesic requirement was significantly less in group BD. Time to request for first analgesic dose was longer in group BD as compared to group B. The duration of analgesia was longest in patients received intravenous dexmedetomidine along with spinal bupivacaine. Hemodynamic parameters and incidence of side effects were similar in both the groups. Conclusion: Premedication with single dose of intravenous dexmedetomidine 0.5 µg/kg prior to subarachnoid blockade with 0.5% hyperbaric bupivacaine hastens the onset and increases duration of sensory and motor block, with maintenance of stable hemodynamics and arousable sedation in Inguinal Herniorrhaphies.
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右美托咪定输注布比卡因蛛网膜下腔阻滞治疗腹股沟疝的前瞻性研究
背景:右美托咪定(D)是一种作为麻醉和镇痛替代品的α -2激动剂。本研究的目的是观察静脉注射右美托咪定对感觉和运动阻滞时间、术后镇痛、镇静程度和副作用的影响。目的:评价右美托咪定输注对成年疝修补术患者脊髓布比卡因镇痛时间的影响及不良反应。材料与方法:前瞻性研究,为期11个月。80例年龄在20 - 60岁的成年人接受疝气修补手术,采用计算机随机化方法分为B组和BD组。将入组患者分为2组,每组40例患者,在蛛网膜下腔阻断0.5%高压布比卡因12.5 mg之前,接受0.5µg/kg右美托咪定静脉注射10 min (BD组)或生理盐水输注(B组)。BD组疼痛评定量表数值得分显著低于BD组,总镇痛需求显著低于BD组。与b组相比,BD组首次申请镇痛剂量的时间更长。静脉注射右美托咪定和脊髓布比卡因的患者镇痛持续时间最长。两组的血流动力学参数和副作用发生率相似。结论:在0.5%高压布比卡因蛛网膜下腔阻断前,单剂量静脉注射右美托咪定0.5µg/kg可加速腹股沟疝疝患者感觉和运动阻滞的发生,延长阻滞持续时间,维持血流动力学稳定和可觉醒镇静。
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