Anaesthesia, Pain & Intensive Care最新文献

{"title":"NSAIDs in COVID-19, friend or foe?","authors":"Reham Mahrous, Amr Abdelnasser, Raghda Fouda, Mohamed Abd Al Moniem Morsy, Omnia Mandour","doi":"10.35975/apic.v27i1.2123","DOIUrl":"https://doi.org/10.35975/apic.v27i1.2123","url":null,"abstract":"At the beginning of COVID-19 pandemic the use of NSAIDS was avoided. This was because the previous studies suggesting that NSAIDs may be associated with increased risk of complications of lower respiratory tract infections. Later on studies involved the patients who used NSAIDs for some chronic conditions and showed no additional harm among these patients. Then many studied assessed the benefit of using NSAIDs in COVID-19 patients for management of pain and fever and showed no additional risk among these patients.
 Key words: COVID-19; pandemic; NSAIDs
 Citation: Mahrous R, Abdelnasser A, Fouda R, Morsy MAAM, Mandour O. NSAIDs in COVID-19, friend or foe? Anaesth. pain intensive care 2022;27(1):119−122; DOI: 10.35975/apic.v27i1.2123
 Received: May 29, 2022; Reviewed: June 28, 2022; Accepted: July 03, 2022","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135395449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post cervical spine surgery hyperpyrexia (108?F) in a patient with COVID-19: a case report","authors":"Mbbs Nimisha Cherunghattil, MD Chinmaya K. Panda, H. M. R. K. Pdf, Dnb Idccm Fellow Niv Mishal Dhawan Md, R. HabibM., Karim, D. Habib, Reazaul Karim","doi":"10.35975/apic.v27i2.2045","DOIUrl":"https://doi.org/10.35975/apic.v27i2.2045","url":null,"abstract":"Perioperative hyperpyrexia raises many questions and can cause permanent brain damage if left untreated. Malignant hyperthermia (MH), although uncommon, but sporadic cases continue to happen and it is potentially life-threatening. It is characterized by sudden rise of body temperatures to above 106 degrees F or even more, and hypercapnia. It is usually associated with anesthetic exposure. However, not every hyperpyrexia is MH;a clinical examination, risk stratification, scoring, and logical approach are required to exclude MH in the postoperative patient. We present a case of rare postoperative hyperpyrexia caused by COVID-19. The patient underwent uneventful spine surgery under general anesthesia and developed hyperpyrexia on the first postoperative day. The case highlights the importance of a logical and systematic approach for excluding the causes of postoperative hyperpyrexia and aggressive management.","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":"28 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90936737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extreme physical exhaustion leading to hypokalemic periodic paralysis- a case report","authors":"Monjuri Borkotokey, K. Dutta","doi":"10.35975/apic.v26i1.1782","DOIUrl":"https://doi.org/10.35975/apic.v26i1.1782","url":null,"abstract":"Sudden onset limb weakness in a young individual requires a thorough evaluation and prompt diagnosis. Delay in treatment awaiting CT scan reports or laboratory investigations can lead to complications. Our case report stresses upon the clinicians to consider hypokalemic periodic paralysis in the differential diagnosis in evaluating such patients. Classical ECG changes and blood gas analysis can effectively diagnose hypokalemia and institute gradual correction of the electrolyte abnormality. In a very rare incident, our patient developed hypokalemia after strenuous exercise. \u0000Key words: Hypokalemic periodic paralysis; Hypokalemia; Flaccid paralysis; Exhaustion \u0000Citation: Borkotokey M, Dutta K. Extreme physical exhaustion leading to hypokalemic periodic paralysis- a case report. Anaesth. pain intensive care 2022;26(1):123-125. \u0000DOI: 10.35975/apic.v26i1.1782 \u0000Received: November 30, 2021, Reviewed: December 25, 2021,, Accepted December 27, 2021","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43172823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difficult airway management in Apert syndrome for maxillofacial reconstruction: a case report","authors":"Purwoko Purwoko, Andre Azhar, S. Permana","doi":"10.35975/apic.v26i1.1781","DOIUrl":"https://doi.org/10.35975/apic.v26i1.1781","url":null,"abstract":"Apert syndrome (AS) is an autosomal dominant disease associated with several craniofacial and limb deformities. Craniofacial deformities in AS patients requiring surgery are usually associated with difficult airway management. We report a case of a 21-year-old male patient, ASA III, with AS, who had a mandibular fracture and reconstruction was planned. The patient had all the features of AS. He had no comorbidities such as hypertension and diabetes mellitus. Awake intubation with fiberoptic bronchoscope was planned. In these patients with AS, intravenous access might also be difficult due to limb deformities. Some surgical procedures make intravenous access even more difficult. Rarely, if intravenous access is judged to be mandatory in an emergency, intraosseous or intramuscular access may be an alternative. \u0000Abbreviations: AS - Apert syndrome; ED - emergency department; MSCT - Multislice Computerized Tomography \u0000Key words: Apert syndrome; Acrocephalosyndactylia / diagnostic imaging; Acrocephalosyndactylia / pathology; Syndactyly / pathology; Maxillofacial reconstruction, Airway management \u0000Citation: Purwoko P, Azhar A, Permana SA. Difficult airway management in Apert syndrome for maxillofacial reconstruction: a case report. Anaesth. pain intensive care 2021;26(1):119-122. \u0000DOI: 10.35975/apic.v26i1.1781 \u0000Received: October 27, 2021, Reviewed: November 11, 2021, Accepted: November 14, 2021","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46879655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of lidocaine infusion compared to dexmedetomidine infusion on proinflammatory cytokines and stress response in pelvi–abdominal cancer surgeries: a randomized clinical trial","authors":"M. M. Hassan, E. Saleh, Norma Osama Abdalla, Noha Hassan Radwan, E. M. Abdelghfar","doi":"10.35975/apic.v26i1.1765","DOIUrl":"https://doi.org/10.35975/apic.v26i1.1765","url":null,"abstract":"Background & Objectives: Stress response to extensive surgeries in cancer patients results in an imbalance between the pro-inflammatory and anti-inflammatory cytokines, besides activating an inflammatory cascade. We investigated the comparative effects of intravenous infusion of dexmedetomidine and lidocaine on proinflammatory cytokines and the stress reaction. \u0000Methodology: A prospective randomized double blind trial was performed in National Cancer Institute. 54 patients scheduled for pelvi–abdominal cancer surgery under general anesthesia were randomly allocated to three equal groups. Lidocaine group: patients received 1.5 mg/kg loading dose of lidocaine followed by 1.5 mg/kg/h infusion; Dexmedetomidine group: received a loading dose of dexmedetomidine 1 µg/kg followed by infusion of 0.5 µg/kg/h; or Saline group: received 50 ml of normal saline followed by infusion at a rate of 10 ml/h till the end of the surgery. The primary outcome was a postoperative target level of IL–6 after 24 h. \u0000Results: Immediate and 24 h postoperative IL–6 and TNFα were significantly lower in both dexmedetomidine and lidocaine groups compared to the control group (P < 0.001). Dexmedetomidine group had a significantly lower IL–6 and TNFα levels compared to lidocaine group at immediate postoperative and 24 h postoperative period (P < 0.001). Dexmedetomidine and lidocaine groups had a significantly lower lactate and insulin levels compared to the control group immediately postoperatively as well as 24 h postoperatively (P < 0.001). The dexmedetomidine group had a significantly lower lactate levels compared to the lidocaine group immediately postoperatively only. The lidocaine group had lower insulin level than the control group regarding immediate postoperative period only. \u0000Conclusion: Intraoperative infusion of dexmedetomidine or lidocaine, both attenuate the postoperative levels of proinflammatory cytokines and stress response in patients undergoing pelvi–abdominal cancer surgeries. \u0000Clinical trial registration: The study was registered at clinicaltrials.gov (NCT 04148599). \u0000Key words: Lidocaine; Dexmedetomidine; Interleukins; Tumor necrosis factor-α; Stress response; Pelvi–abdominal cancer; Surgery \u0000Abbreviations: TNF - Tumor necrosis factor; IL – Interleukins; \u0000Citation: Hassan MM, Saleh RG, Abdalla NO, Radwan NH, Abdelghfar EM. Effect of lidocaine infusion compared to dexmedetomidine infusion on proinflammatory cytokines and stress response in pelvi–abdominal cancer surgeries: a randomized clinical trial. Anaesth. pain intensive care 2021;26 (1):44-52. \u0000DOI: 10.35975/apic.v26i1.1765 \u0000Received: February 15, 2021, Reviewed: December 02, 2021, Accepted: December 05, 2021","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48160809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of intrathecal fentanyl and buprenorphine as adjuvants to bupivacaine in gynecological surgery","authors":"Y. Singh, Adarsh Kumar Yadav, Vijeta Bajpai, Priyanka Diwedi, S. Verma, R. Verma","doi":"10.35975/apic.v26i1.1764","DOIUrl":"https://doi.org/10.35975/apic.v26i1.1764","url":null,"abstract":"Background & Objective: Hyperbaric bupivacaine is the most commonly used local anesthetic for spinal anesthesia, alone or in combination with various adjuvants. Opioids are frequently used for their rapid onset and intense block characteristics. Fentanyl is the preferred intrathecal opioids with rapid onset of action but has a shorter duration of action. Buprenorphine is a mixed agonist-antagonist with high affinity at both mu and kappa opioid receptors. We compared administration of buprenorphine with fentanyl as adjuvants with intrathecal hyperbaric bupivacaine in gynecological surgeries. \u0000Methodology: After Institutional Ethical Committee approval and written informed consent, 60 patients aged 18–65 y, scheduled for lower abdominal gynecological surgery, were divided into two equal groups; Group F to receive 0.5% hyperbaric bupivacaine 2.5 ml with fentanyl 25 µg intrathecal and Group B to receive 0.5% hyperbaric bupivacaine 2.5 ml with buprenorphine 75 µg intrathecal. Block characteristics and associated side effects were compared between two groups. The data was analyzed using Chi square test and Fisher’s exact test. For comparing two group of mean, independent student’s t test was used. P-value < 0.05 was considered as statistically significant. \u0000Results: The mean onset of sensory and motor block was significantly earlier in Group F than Group B (p < 0.001). Mean duration of sensory block was significantly prolonged in Group B compared to Group F (p < 0.05). Whereas, the duration of motor was comparable in both of the groups (p > 0.05). Duration of analgesia was significantly prolonged in Group B than Group F (p < 0.001). \u0000Conclusion: We conclude that when a longer duration of postoperative pain relief is needed, buprenorphine can be a suitable drug to be used with intrathecal hyperbaric bupivacaine for gynecological surgeries because of prolonged duration of action. \u0000Key words: Spinal anesthesia; Fentanyl; Buprenorphine; Bupivacaine \u0000Citation: Singh Y, Yadav AK, Vijeta Bajpai, Diwedi P, Verma S, Verma RK. Comparison of intrathecal fentanyl and buprenorphine as adjuvants to bupivacaine in gynecological surgery. Anaesth. pain intensive care 2021;26(1):39-43. \u0000DOI: 10.35975/apic.v26i1.1764","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47662591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthesia without opioids","authors":"M. Butt, Asma Faraz, M. Fazal","doi":"10.35975/apic.v26i1.1758","DOIUrl":"https://doi.org/10.35975/apic.v26i1.1758","url":null,"abstract":"Summary \u0000Opium was the first opioids with sedative and analgesic effects, so was readily adopted by the surgical doctors to be used during surgeries. Later on its natural alkaloid, morphine, was extensively used, till synthetic alkaloids were introduced in the clinical practice. Now many non-narcotic analgesic drugs have been synthesized and proven to be devoid of serious side effects, commonly associated with the opioid use. There have been some staunch advocates of non-narcotic based anesthesia, who claim that the side effects of the opioids outweigh their benefits in the anesthesia. This editorial throws some light on the current and the future trends in analgesic use in anesthesia. \u0000Key words: Opioids; Analgesics; Non-opioid analgesics; Perioperative pain; Side effects \u0000Citation: Butt MN, Faraz A, Fazal M. Anesthesia without opioids (Editorial). Anaesth. pain intensive care 2021;26(1):4–7; \u0000DOI: 10.35975/apic.v26i1.1758 \u0000Received: January 10, 2022, Accepted: January 12, 2022","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42896506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of LMA Supreme™ vs. LMA ProSeal™ for ambulatory surgeries in adult patients","authors":"Amanjot Singh, J. Kaur, S. Kaur, K. Gupta","doi":"10.35975/apic.v26i1.1769","DOIUrl":"https://doi.org/10.35975/apic.v26i1.1769","url":null,"abstract":"Background & objectives: The laryngeal mask airway Supreme™ (LMA-S) is a new, single-use, supraglottic device that combines the functionality of the ProSeal™ and Fastrach™ airways. Till now, there have been conflicting results regarding the oropharyngeal leak pressure (OLP) of the LMA Supreme™ vs. the LMA ProSeal™, which is the major determinant of effective ventilation and airway protection during LMA use. We compared the safety and efficacy of the LMA ProSeal™ vs. the LMA Supreme™ in ambulatory surgeries. \u0000Methodology: In this prospective, comparative trial, eighty adult patients undergoing elective surgery, were randomly allocated to one of the two groups: Group LMA–P (LMA ProSeal™ group) and Group LMA–S (LMA Supreme™ group) of 40 patients each. OLP, insertion times, number of insertion attempts, ease of insertion and pharyngolaryngeal morbidity were assessed. Statistical analysis was performed using SPSS version 21.0 software using Student’s t-test and Chi-square test. P < 0.05 was considered to be statistically significant. \u0000Results: Oropharyngeal leak pressure in Group LMA–P (26.65 ± 1.59 cmH2O) was comparable to Group LMA–S (26.08 ± 1.67 cmH2O) and both provided adequate seal and effective ventilation. The mean effective airway time was significantly less in Group LMA–S as compared to Group LMA–P (14.80 ± 1.24 sec and 17.80 ± 1.47 sec) respectively. Mean number of successful insertion attempts, hemodynamic response and pharyngolaryngeal morbidity were comparable in both the groups. \u0000Conclusion: Both LMA Supreme™ and LMA ProSeal™ are equally efficacious and safe for maintaining airway and ventilation in paralyzed patients. However, LMA Supreme™ is easier to insert with shorter effective airway time than LMA ProSeal™. \u0000Abbreviations: SAD - Supraglottic airway device; ETI - Endotracheal intubation; LMA - Laryngeal mask airways; PPV - Positive pressure ventilation; OLP - oropharyngeal leak pressure \u0000Key words: LMA ProSeal™, LMA Supreme™, Oropharyngeal leak pressure; Airway; Aieway management \u0000Citation: Singh A, Kaur J, Kaur S, Gupta KK. Safety and efficacy of LMA Supreme™ vs. LMA ProSeal™ for ambulatory surgeries in adult patients. Anaesth. pain intensive care 2021;26(1):63-68. \u0000DOI: 10.35975/apic.v26i1.1769 \u0000Received: June 02, 2021, Reviewed: December 13, 2021, Accepted: December 15, 2021","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43145630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bispectral index monitoring in spinal anesthesia with sedation can prevent dexmedetomidine related bradycardia: a randomized clinical trial","authors":"Jiwook Kim, H. Kim, M. Yun, J. Lee, Joo-Duck Kim, D. Kang","doi":"10.35975/apic.v26i1.1760","DOIUrl":"https://doi.org/10.35975/apic.v26i1.1760","url":null,"abstract":"Background: An unintentional large dose of dexmedetomidine during sedation can lead to increased side effects such as bradycardia and hypotension. We investigated whether the frequency of bradycardia in patients undergoing surgery under spinal anesthesia and sedation with dexmedetomidine was effected if bispectral index (BIS) was used to monitor the sedation. \u0000Methodology: Fifty patients between 20 and 60 y of age, who underwent spinal anesthesia, were included in this study. The patients were divided into two groups (control and BIS groups). Patients in the control group were administered a loading dose of 1 μg/kg dexmedetomidine for the first 10 min without BIS monitoring, followed by a maintenance dose of 0.2 μg/kg/h. Patients in the BIS group received a loading dose of 1 μg/kg dexmedetomidine for the first 10 min. The maintenance dose in this group was administered at the discretion of the anesthesiologist to maintain the BIS score between 50 and 70. The baseline heart rate (HR), lowest HR, and the difference between baseline and the lowest HR were calculated. \u0000Results: The baseline HR was 74.4 ± 11.0 beats per minute (bpm) and 80.9 ± 16.0 bpm, in the control and BIS groups respectively (p = 0.098). The difference between the baseline and lowest HR in the control and BIS groups was 19.4 ± 7.6 bpm and 25.5 ± 8.8 bpm, respectively (p = 0.011). Low baseline HR was positively correlated with a reduced lowest HR. \u0000Conclusions: The frequency of bradycardia during sedation with dexmedetomidine decreased with BIS monitoring. Patients with a low baseline HR were more likely to develop bradycardia during sedation with dexmedetomidine. Therefore, BIS monitoring may be helpful in patients with low baseline HR. \u0000Key words: Bispectral index monitor; Dexmedetomidine; heart rate; spinal anesthesia \u0000Citation: Kim J, Kim HY, Yun M, Lee J, Kim JD, Kang D. Bispectral index monitoring during sedation with dexmedetomidine in spinal anesthesia prevents bradycardia: a randomized clinical trial. Anaesth. pain intensive care 2021;26(1):14-19 ; \u0000DOI: 10.35975/apic.v26i1.1760","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49506702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of three different doses of intrathecal dexmedetomidine on subarachnoid block: a prospective randomized double-blind trial","authors":"Ashita Mowar, Vishwadeepak Singh, A. Pahade, Geeta Karki","doi":"10.35975/apic.v26i1.1759","DOIUrl":"https://doi.org/10.35975/apic.v26i1.1759","url":null,"abstract":"Background: Dexmedetomidine has increasingly been used in regional anesthesia as an adjuvant, but there is still no consensus on the optimum dose when it is used intrathecally. We conducted this study to elucidate the dose-response relation between three different doses of intrathecal dexmedetomidine (2.5, 5, or 10 µg) as an adjuvant to 0.5% hyperbaric bupivacaine in patients undergoing elective lower abdominal and lower limb surgeries. \u0000Methodology: 90 patients, aged 18-60 y, were randomized into three groups of 30 patients each. Group A received 0.5% hyperbaric bupivacaine 12.5 mg (2.5 ml) with 2.5 µg dexmedetomidine, Group B received 5 µg dexmedetomidine with bupivacaine, and Group C received 10 µg dexmedetomidine with bupivacaine. Duration of the spinal sensory blockade (primary outcome), onset of the blockade, time to rescue analgesia, level of sedation, duration of motor blockade, comparison of hemodynamic variables and complications, if any were assessed. \u0000Results: There was a significant dose dependent prolongation of sensory block; Group A - 250.67 ± 51.39, Group B - 286 ± 52.76, and Group C - 351.00 ± 47.00 min; (p < 0.001), motor block; Group A - 255.53 ± 44.25, Group B - 312 ± 29.64, and Group C - 361.4 ± 16.14 min (p < 0.001). Time to two segment regression was 132.33 ± 48.29, 148.77 ± 48.89, 171.57 ± 25.46 min (p = 0.002) and time for rescue analgesia was 351.33 ± 101.19, 472.00 ± 24.41, 738.00 ± 67.79 min (p < 0.001). VAS was significantly low in Group C (p < 0.05). Intergroup hemodynamic parameters were comparable (p > 0.05) without any appreciable side effects. \u0000Conclusion: Spinal dexmedetomidine increases the sensory and motor block durations as well as time to first analgesic use, and decreases analgesic consumption in a dose-dependent manner, when used with hyperbaric bupivacaine. \u0000Abbreviations: IT - Intrathecal; ITD - Intrathecal Dexmedetomidine; SAB - Subarachnoid Block; VAS - Visual Analogue Scale; BMI - Body Mass Index; NIBP - Non-Invasive Blood Pressure; RSS - Ramsay Sedation Score; TSSR - Two segment sensory regression; ANOVA - Analysis of Variance; OSB - Onset of sensory block, TSSRT - Two segment sensory regression time; Duration of sensory blockade; OMB - Onset of motor block; DMB - Duration of motor blockade \u0000Key words: Dexmedetomidine; Bupivacaine; Anesthesia, Spinal; Dexmedetomidine; Post-operative analgesia \u0000Citation: Mowar A, Singh V, Pahade A, Karki G. Effect of three different doses of intrathecal dexmedetomidine on subarachnoid block: a prospective randomized double-blind trial. Anaesth. pain intensive care 2021;26(1):8–13; \u0000DOI: 10.35975/apic.v26i1.1759 \u0000Received: July 24, 2021, Reviewed: November 18, 2021, Accepted: November 28, 2021","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43196329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}