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Abstract
Objective: Spinal saddle anaesthesia is the most prevalent method for perineal surgeries. Dexmedetomidine, a unique medication that acts on α2-adrenergic receptors in the spinal cord, relieves pain. The goal is to assess the efficacy of intrathecal dexmedetomidine in combination with bupivacaine.
Methods: A total of 60 patients undergoing elective uncomplicated peri anal surgeries were included in the study. 30 patients were in the 0.75% hyperbaric Bupivacaine group (Group A) and 30 patients were in the 0.75% hyperbaric Bupivacaine with Dexmedetomidine 5 mcg group (Group B). Intensity of pain was analysed through the Visual analogue pain score VAS which was described to the patients on a scale from 0-10 (No pain to severe pain). Mean analgesia duration was measured from time 0 of SSB until the patient asked for additional pain killers (VAS score >4).
Results: The mean duration of surgery was 29.866±1.87 minutes in group A and 28.866±2.06 minutes in group B. Motor block was of lesser duration in group A (152.90±9.09 minutes) as compared to group B (203.00±18.95 minutes) with p<0.05. Mean analgesia duration was significantly prolonged in group B (630.66±78.50 minutes) versus group A (325.33±36.67 minutes) with a statistically significant p-value. (p<0.05) Postoperatively, a lower frequency of painkiller demands was made by group B patients in 24 hours. (p<0.05)
Conclusion: In SSB, Dexmedetomidine added to Bupivacaine intrathecally increases the duration of analgesia postoperatively.
References
Gautam B, Lama SM, Sharma M. Effects of Adding Intrathecal Dexmedetomidine to Hyperbaric Bupivacaine for Saddle Spinal Block in Adults Undergoing Peri-anal Surgeries. J Nepal Health Res Counc. 2018 Mar 13;16(1):43-48. PMID: 29717288.
Amin SR, Souidan I, Abdelzaam EM. Intrathecal midazolam is a comparable alternative to fentanyl and nalbuphine as adjuvant to bupivacaine in spinal anesthesia for elective cesarean section: A randomized controlled double blind trial. Anaesth. Pain Intensive Care 2022; 27(1); 89-96; https://doi.org/10. 35975/apic.v27i1.1923.
Shashikala TK, Sagar SS, Ramaliswamy P, Hudgi VV. Comparing effects of intrathecal adjuvants fentanyl and dexmedetomidine with hyperbaric ropivacaine in patients undergoing elective infraumbilical surgeries: A prospective, double-blind, clinical study. Anesth Essays Res 2019; 13(4):654-62. https://doi.org/10.4103/aer.AER_183_18.
Farooq S, Rizvi MFA, Yousuf SMA, Dilshad R, Bashir G, Dilshad A. Comparing intrathecal dexmedetomidine and fentanyl as adjuvants to hyperbaric bupivacaine in elective caesarian section, a study. Professional Med J 2022; 29(2):218-26. https://doi.org/10.29309/TPMJ/2022.29.02.6414.
Taha Mohammed LA, Ibrahim SF, Abd El-Fattah Ghoniem MM, El-Sayed Ahmed IM. A comparative study between intrathecal fentanyl and dexmedetomidine as adjuvants to hyperbaric levobupivacaine 0.5% in patients undergoing infra umbilical surgeries. QJM An International J Med 2021; 114(Suppl 1): hcab086.047. https://doi.org/10.1093/qjmed/hcab086. 047.
Kaur N, Goneppanavar U, Venkateswaran R, Iyer SS. Comparative Effects of Buprenorphine and Dexmedetomidine as Adjuvants to Bupivacaine Spinal Anaesthesia in Elderly Male Patients Undergoing Transurethral Resection of Prostrate: A Randomized Prospective Study. Anesth Essays Res. 2017 Oct-Dec;11(4):886-891. https://doi.org/10.4103/aer.AER_163_17.
Vukovic I, Duplancic B, Benzon B, Dogas Z, Kovac R, Pecotic R. Midazolam versus dexmedetomidine in patients at risk of obstructive sleep apnea during urology procedures: A randomized controlled trial. J Clin Med 2022; 11(19):5849. https://doi.org/10.3390/Jcm11195849.
Bharthi Sekar E, Vijayaraghavan U, Sadiqbasha AM. Effect of Intravenous Dexmedetomidine on Spinal Anesthesia. Cureus. 2021 Jun 17;13(6):e15708. https://doi.org/10.7759/cureus.15708.
Alam SS, Abbas N, Asgher A, Rafique M, Anees-ur-Rehman, Abid K. Effectiveness of intrathecal dexmedetomidine in combination with hyperbaric bupivacaine for lower abdominal surgeries and its postoperative analgesic characteristic. J Ayub Med Coll Abbottabad 2022; 34(Suppl 1)(4):S936-9. https://doi.org/10.55519/JAMC-04-S4-10179.
Mo X, Huang F, Wu X, Feng J, Zeng J, Chen J. Intrathecal dexmedetomidine as an adjuvant to plain ropivacaine for spinal anesthesia during cesarean section: a prospective, double-blinded, randomized trial for ED50 determination using an up-down sequential allocation method. BMC Anesthesiol. 2023 Sep 25;23(1):325. https://doi.org/10.1186/s12871-023-02275-x.
Sudheesh K, Rao RR, Kavya M, Aarthi J, Rani DD, Nethra SS. Comparative study of two doses of intrathecal dexmedetomidine as adjuvant with low dose hyperbaric bupivacaine in ambulatory perianal surgeries: A prospective randomised controlled study. Indian J Anaesth. 2015 Oct;59(10):648-52. https://doi.org/10.4103/0019-5049.167485.
Siddiq S, Siddiq M, Khaleeq S, Rehman AU, Raza D, Asad N. Study of effect of adding two different doses of dexmedetomidine as an adjuvant to low dose bupivacaine in saddle block for transurethral resection of prostate in elderly patients. Ann King Edward Med Uni 2020; 26(3): 485-90. https://doi.org/10.21649/akemu.v26i3.4147.
Chattopadhyay I, Banerjee SS, Jha AK, Basu S. Effects of intrathecal dexmedetomidine as an additive to low-dose bupivacaine in patients undergoing transurethral resection of prostate. Indian J Anaesth 2017; 61(12):1002-8. https://doi.org/10.4103/ija.IJA_324_16.
Patodi V, Jain K, Sharma A, Singh M. Efficacy of dexmedetomidine as an adjuvant to low-dose bupivacaine for postoperative analgesia in patients undergoing transurethral resection of prostate under subarachnoid block. J Evolution Med Dent Sci 2020; 9(50):3794-9. https://doi.org/10.14260/jemds/2020/ 832.
Kim JE, Kim NY, Lee HS, Kil HK. Effects of intrathecal dexmedetomidine on low-dose bupivacaine spinal anesthesia in elderly patients undergoing transurethral prostatectomy. Biol Pharm Bull. 2013;36(6):959-65. https://doi.org/10.1248/bpb.b12-01067.
Devanand J, Selvamani S. Intrathecal dexmedetomidine as adjuvant for spinal anaesthesia for perianal ambulatory surgeries: A randomised double-blind controlled study. World J Pharmaceutical Res 2017; 6(16): 680-8. https://doi.org/10.20959/wjpr 201716-10201.
Gupta R, Bogra J, Verma R, Kohli M, Kushwaha JK, Kumar S. Dexmedetomidine as an intrathecal adjuvant for postoperative analgesia. Indian J Anaesth. 2011 Jul;55(4):347-51. https://doi.org/10.4103/0019-5049.84841.
Nethra SS, Sathesha M, Dixit A, Dongare PA, Harsoor SS, Devikarani D. Intrathecal dexmedetomidine as adjuvant for spinal anaesthesia for perianal ambulatory surgeries: A randomised double-blind controlled study. Indian J Anaesth. 2015 Mar;59(3):177-81. https://doi.org/10.4103/0019-5049.153040.
Yektaş A, Belli E. The effects of 2 µg and 4 µg doses of dexmedetomidine in combination with intrathecal hyperbaric bupivacaine on spinal anesthesia and its postoperative analgesic characteristics. Pain Res Manag. 2014 Mar-Apr;19(2):75-81. https://doi.org/10.1155/2014/956825. Epub 2014 Feb 13.
Naaz S, Bandey J, Ozair E, Asghar A. Optimal dose of intrathecal dexmedetomidine in lower abdominal surgeries in average indian adult. J Clin Diagn Res 2016; 10(4): UC09-13. https://doi.org/10.7860/JCDR/2016/18008.7611.
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