Efficacy of different doses of dexmedetomidine as an adjuvant to bupivacaine in sub-arachnoid block for patients undergoing lower limb surgeries
Keywords:
anestheisa, spinal anesthesia, bupivacaine, dexmedetomidine, lower limb surgeryAbstract
Objective: To determine the difference in efficacy of bupivacaine as adjuvant to 5 µg& 10 µg of dexmedetomidine respectively during intrathecal administration in prolongation of duration of sensory block (as a main primary variable) in lower limb orthopedic surgery. Setting: Department of anesthesia, MTI-HMC, Peshawar. Study design: Randomized controlled trails. Duration of study: From 1st Feb 2021 to 30th July 2021. Subjects & Methods: Each patient enrolled in study after proper consent in written form and counselling was subjected to complete medical history, clinical examination. Spinal column was the primary focus of examination. All standard vitals monitoring equipment attahed. Baseline readings obtained and noted. Double i/v line was secured. Patients were preloaded with 10ml/ kg of Ringer Lactate. Spinal injection of anesthetic. Conclusion: Results obtained from this study showed that adding 10 micro gram of dexmeditomidine in comparison to 5 micro gram to spinal anesthetic for lower limb traumatic orthopedic surgery significantly prolongs the sensory block, analgesia, decreased onset time for block, early rehabilitaion and ambulation of patients which has various socioecnomic advantages.
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Berninger MT, Friederichs J, Leidinger W, Aught P, Bühren V, Fulghum C, Reng W. Effect of local infiltration analgesia, peripheral nerve blocks, general and spinal anesthesia on early functional recovery and pain control in unicompartmental knee arthroplasty. BMC musculoskeletal disorders. 2018 Dec 1; 19(1):249.
Sun Y, Xu Y, Wang GN. Comparative evaluation of intrathecal bupivacaine alone, bupivacaine-fentanyl, and bupivacaine-dexmedetomidine in caesarean section. Drug research. 2015 Sep; 65(09):468-72..
Bohringer C, Liu H. Is It Time for an Expanded Role of Dexmedetomidine in Contemporary Anesthesia Practice?-A Clinician’s Perspective. Translational perioperative and pain medicine. 2018; 5(3):55.
Halder, Susanta et al. “Effect of different doses of dexmedetomidine as adjuvant in bupivacaine -induced subarachnoid block for traumatized lower limb orthopaedic surgery: a prospective, double-blinded and randomized controlled study.” Journal of clinical and diagnostic research: JCDR vol. 8, 11 (2019): GC01-6. doi:10.7860/JCDR/2019/9670.5118
Nwachukwu C, Idehen HO, Edomwonyi NP, Umeh B. Postoperative analgesic effect of intrathecal dexmedetomidine on bupivacaine subarachnoid block for open reduction and internal fixation of femoral fractures. Niger J Clin Pract 2020;23:172-8
Gupta R, Bogra J, Verma R, Kohli M, Kushwaha JK, Kumar S. Dexmedetomidine as an intrathecal adjuvant for postoperative analgesia. Indian journal of anaesthesia. 2011 Jul;55(4):347.
Esmaoğlu A, Türk S, Bayram A, Akın A, Uğur F, Ülgey A. The effects of dexmedetomidine added to spinal levobupivacaine for transurethral endoscopic surgery. Balkan medical journal. 2013 Jun;30(2):186
Kanazi GE, Aouad MT, Jabbour‐Khoury SI, Al Jazzar MD, Alameddine MM, Al‐Yaman R, Bulbul M, Baraka AS. Effect of low‐dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Acta anaesthesiologica scandinavica. 2006 Feb;50(2):222-7.
Al-Ghanem SM, Massad IM, Al-Mustafa MM, Al-Zaben KR, Qudaisat IY, Qatawneh AM, Abu-Ali HM. Effect of adding dexmedetomidine versus fentanyl to intrathecal bupivacaine on spinal block characteristics in gynecological procedures: A double blind controlled study. American journal of applied sciences. 2009;6(5):882
Perlas A, Kirkham KR, Billing R, Tse C, Brull R, Gandhi R, Chan VW. The impact of analgesic modality on early ambulation following total knee arthroplasty. Regional Anesthesia & Pain Medicine. 2013 Jul 1;38(4):334-9.
Wu JJ, Lollo L, Grabinsky A. Regional anesthesia in trauma medicine. Anesthesiology research and practice. 2011 Jan 1;2011.
Concepcion MA. Spinal anesthetic agents. International anesthesiology clinics. 1989 Jan 1;27(1):21-5.
Wang JK, Nauss LA, Thomas JE. Pain relief by intrathecally applied morphine in man. Survey of Anesthesiology. 1979 Dec 1;23(6):384.
Busch-Dienstfertig M, Stein C. Opioid receptors and opioid peptide-producing leukocytes in inflammatory pain–basic and therapeutic aspects. Brain, behavior, and immunity. 2010 Jul 1;24(5):683-94.
Stein CH, Millan MJ, Shippenberg TS, Peter KL, Herz AL. Peripheral opioid receptors mediating antinociception in inflammation. Evidence for involvement ofmu, delta and kappa receptors. Journal of Pharmacology and Experimental Therapeutics. 1989 Mar 1;248(3):1269-75.
Henneberg SW, Hole P, HAAS IM, Jensen PJ. Epidural morphine for postoperative pain relief in children. Acta anaesthesiologica scandinavica. 1993 Oct;37(7):664-7.
Krane EJ, Jacobson LE, Lynn AM, Parrot C, Tyler DC. Caudal morphine for postoperative analgesia in children: a comparison with caudal bupivacaine and intravenous morphine. Anesthesia and analgesia. 1987 Jul 1;66(7):647-53.
Karaman S, Kocabas S, Uyar M, Hayzaran S, Firat V. The effects of sufentanil or morphine added to hyperbaric bupivacaine in spinal anaesthesia for caesarean section. European journal of anaesthesiology. 2006 Apr;23(4):285-91.
Cormack JR, Orme RM, Costello TG. The role of α2-agonists in neurosurgery. Journal of Clinical Neuroscience. 2005 May 1;12(4):375-8.
Schnaider TB, Vieira AM, Brandão AC, Lobo MV. Intraoperative analgesic effect of epidural ketamine, clonidine or dexmedetomidine for upper abdominal surgery. Revista brasileira de anestesiologia. 2005;55:525-31.
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