Evaluation of the effect of intravenous dexmedetomidine on characteristics of spinal anaesthesia with hyperbaric bupivacaine

Rajabi Majid, Mukesh Somvanshi, A. Tripathi, Varalakshmi Karasala
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Abstract

Aims: A study was performed to evaluate the effect of intravenously administered dexmedetomidine just before spinal anaesthesia, on spinal block characteristics, postoperative analgesia, haemodynamics and sedation. Methods: Sixty patients, aged 18 - 50 years of either sex, ASA grade I & II, who were undergoing elective lower abdominal and lower limb surgeries under spinal anaesthesia with hyperbaric bupivacaine, were randomly allocated in to two equal groups of 30 patients each to recieve 20 ml of normal saline intravenously (group A) and intravenous dexmedetomidine 0.5 mcg/kg prepared in normal saline to a total volume of 20 ml (group D) over a 10 min period as a single dose just before spinal anaesthesia. Onset and duration of sensory blocks and motor blocks, highest sensory block level, time to 2 segment regression, duration of analgesia, perioperative haemodynamic parameters, VAS and sedation scores were assessed. Results: Both groups were comparable with regard to demographic data. The onset of sensory and motor block were significantly earlier in group D as compared to group A. Duration of motor block and analgesia were significantly longer in group D as compared to group A. Sedation score were significantly higher in group D. Though HR and NIBP were significantly decreased in group D, however all patients remained haemodynamically stable. Conclusion: Bolus dose of intravenous dexmedetomidine 0.5 µg/ kg administered just before spinal anaesthesia prolongs the duration of sensory – motor block and postoperative analgesia with arousable sedation.
静脉注射右美托咪定对高压压布比卡因脊髓麻醉特点的影响
目的:本研究评价脊髓麻醉前静脉给予右美托咪定对脊髓阻滞特征、术后镇痛、血流动力学和镇静的影响。方法:60岁患者,18 - 50岁的性爱,ASA I和II级,择期下腹部及下肢手术根据与高压bupivacaine脊髓麻醉,被随机分配到两组30例每个接待20毫升生理盐水静脉注射(A组)和正常生理盐水静脉dexmedetomidine 0.5微克/公斤准备20毫升的总量(D组)在10分钟内一剂在脊髓麻醉。评估感觉阻滞和运动阻滞的发生时间和持续时间、最高感觉阻滞水平、2段回归时间、镇痛时间、围手术期血流动力学参数、VAS评分和镇静评分。结果:两组人口学数据具有可比性。D组感觉阻滞和运动阻滞的发病时间明显早于a组,运动阻滞和镇痛持续时间明显长于a组。D组镇静评分明显高于D组,虽然D组HR和NIBP明显降低,但所有患者血流动力学均保持稳定。结论:脊髓麻醉前静脉注射右美托咪定0.5µg/ kg可延长感觉运动阻滞持续时间,术后可唤醒镇静镇痛。
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