Comparative study of Intravenous Dexmedetomidine as Premedication versus supplementation for spinal anaesthesia with Intrathecal 0.75% Isobaric Ropivacaine in elective lower limb surgeries and lower abdominal surgeries
Government general hospital, Nizamabad
Keywords:
Dexmedetomidine, Isobaric ropivacaine, Intrathecal, Supraclavicular, Sensory blockAbstract
Background: Spinal anesthesia is commonly administered intraoperatively. However, relative short duration of action is associated with local anesthetics. A variety of adjuvants is used for prolongation of postoperative analgesia. Aims and Objectives: Comparative analysis of intravenous dexmedetomidine as a premedication and spinal anesthesia treatment with intrathecal isobaric ropivacain of 0.75% in elective lower limb surgery and lower abdominal surgery. Material and Methods: Following approval by the ethical committee, 60 patients scheduled for elective lower limb orthopedic surgery and lower abdominal surgery were chosen and randomized into two groups (n=30). The patient was then intrathecally administered 3 ml amount of 0.75 percent isobaric ropivacaine in lateral location. Another syringe containing dexmedetomidine was given after 10 minutes of placement, for 10 minutes using syringe pump. Comparison of sensory block initiation, analgesic effects and hemodynamic effects was made between the 2 classes. Results: Comparison of age distribution of (P=0.164) was not statistically important. In Group P, the median age was (40.96 ± 15.3 years) and in Group S (44.33 ± 12.66 years).
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Mauermann WJ, Shilling AM, Zuo Z. A comparison of neuraxial block versus general anesthesia for elective total hip replacement: a meta-analysis. Anesthesia & Analgesia. 2006;103(4):1018-25..
Gottschalk A, Durieux ME, Nemergut EC. Intraoperative methadone improves postoperative pain control in patients undergoing complex spine surgery. Anesthesia & Analgesia. 2011;112(1):218-23.
Borah TJ, Dey S, Yunus M, Dev P, Karim HM, Bhattacharyya P. Effect of different doses of intrathecal nalbuphine as adjuvant to ropivacaine in elective lower limb surgeries: A dose finding study. Indian Journal of Anaesthesia. 2018;62(11):865-70
Ture P, Ramaswamy AH, Shaikh SI, Alur JB, Ture AV. Comparative evaluation of anaesthetic efficacy and haemodynamic effects of a combination of isobaric bupivacaine with buprenorphine vs. isobaric levobupivacaine with buprenorphine for spinal anaesthesia–A double blinded randomised clinical trial. Indian journal of anaesthesia. 2019;63(1):49-54.
Solanki SL, Bharti NA, Batra YK, Jain A, Kumar P, Nikhar S. The analgesic effect of intrathecal dexmedetomidine or clonidine, with bupivacaine, in trauma patients undergoing lower limb surgery: a randomised, double-blind study. Anaesthesia and intensive care. 2013;41(1):51-6.
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 research and management. 2014;19:75‑81.
Annamalai A, Singh S, Singh A, Mahrous DE. Can intravenous dexmedetomidine prolong bupivacaine intrathecal spinal anesthesia?. J Anesth Clin Res 2013;4:372.
Hansen TG. Ropivacaine: a pharmacological review. Expert review of neurotherapeutics. 2004 ;4(5):781-91.
Kokki H, Ylönen P, Laisalmi M, Heikkinen M, Reinikainen M. Isobaric ropivacaine 5 mg/ml for spinal anesthesia in children. Anesthesia & Analgesia. 2005;100(1):66-70.
Åkerman B, Hellberg IB, Trossvik C. Primary evaluation of the local anaesthetic properties of the amino amide agent ropivacaine (LEA 103). Acta anaesthesiologica scandinavica. 1988;32(7):571-8.
Swami SS, Keniya VM, Ladi SD, Rao R. Comparison of dexmedetomidine and clonidine (α2 agonist drugs) as an adjuvant to local anaesthesia in supraclavicular brachial plexus block: A randomised double-blind prospective study. Indian journal of anaesthesia. 2012;56(3):243.
Niu XY, Ding XB, Guo T, Chen MH, Fu SK, Li Q. Effects of Intravenous and Intrathecal Dexmedetomidine in Spinal Anesthesia: A Meta‐Analysis. CNS neuroscience & therapeutics. 2013;19(11):897-904.
Abdallah FW, Abrishami A, Brull R. The facilitatory effects of intravenous dexmedetomidine on the duration of spinal anesthesia: a systematic review and meta-analysis. Anesthesia & Analgesia. 2013;117(1):271-8.
Tarbeeh GA, Mohamed AA. Effects of intrathecal bupivacaine, fentanyl versus bupivacaine–dexmedetomidine in diabetic surgical patients. Egyptian journal of anaesthesia. 2013;29(1):13-8.
Harsoor SS, Rani DD, Yalamuru B, Sudheesh K, Nethra SS. Effect of supplementation of low dose intravenous dexmedetomidine on characteristics of spinal anaesthesia with hyperbaric bupivacaine. Indian Journal of Anaesthesia. 2013;57(3):265.
Kaya FN, Yavascaoglu B, Turker G, Yildirim A, Gurbet A, Mogol EB, Ozcan B. Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia. Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 2010 ;57(1):39-45.
Gupta K, Tiwari V, Gupta PK, Pandey MN, Agarwal S, Arora A. Prolongation of subarachnoid block by intravenous dexmedetomidine for sub umbilical surgical procedures: A prospective control study. Anesthesia, Essays and Researches. 2014;8(2):175.
Gertler R, Brown HC, Mitchell DH, Silvius EN. Dexmedetomidine: a novel sedative-analgesic agent. InBaylor University Medical Center Proceedings. BUMC Proceedings 2001;14:13–21
Lee MH, Ko JH, Kim EM, Cheung MH, Choi YR, Choi EM. The effects of intravenous dexmedetomidine on spinal anesthesia: comparision of different dose of dexmedetomidine. Korean journal of anesthesiology. 2014 Oct;67(4):252.
Hamed AM, Talaat SM. Effect of intravenous versus intrathecal low-dose dexmedetomidine on spinal block in lower limb orthopedic surgery. Ain-Shams Journal of Anaesthesiology. 2014;7(2):205.
Kumar SK, Kumar CA, Murthy SG. A Comparative Prospective, Randomised, Double Blind Study of the Effect of IV Dexmeditomidine on Subarachnoid Block Versus 0.9 % Normal Saline as Control. Sch J App Med Sci. 2014; 2(5A):1517-1523.
Reddy V, Shaik N, Donthu B, Sannala V, Jangam V. Intravenous dexmedetomidine versus clonidine for prolongation of bupivacaine spinal anesthesia and analgesia: A randomized double-blind study. Journal of Anaesthesiology Clinical Pharmacology. 2013; 29(3):342.
Elcicek K, Tekin M, Kati. The effects of intravenous dexmedetomidine on spinal hyperbaric ropivacaine anesthesia. Journal of Anesthesia. 2010; 24(4):544-548.
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