Block Characteristics and hemodynamic parameters following intra-thecal Hyperbaric 0.5% Bupivacaine with Dexmedetomidine and Hyperbaric 0.5% Bupivacaine alone in lower abdominal Surgeries

Abstract

Introduction: Spinal anaesthesia is a commonly used technique in anaesthetic practice for gynaecological, lower abdominal, pelvic, and lower limb surgeries. Spinal anesthesia is commonly used for surgery because of ease of administration. The Objective of this manuscript mainly focused the comparative evaluation of block characteristics and hemodynamic parameters following intrathecal hyperbaric 0.5% bupivacaine with dexmedetomidine and hyperbaric 0.5% bupivacaine alone in lower abdominal surgeries. Methods: A total of 100 patients of surgery were randomly assigned in two groups. Group A– Patients who had received 3.0 ml of 0.5% Bupivacain (Heavy)+0.5 ml normal saline and served as control group. Group B– Patients who were administered 3.0 ml of 0.5% Bupivacaine (Heavy) mixed with 5μg Dexmedetomidine (0.5 ml ). All patients included in the study were normotensive and had no co-morbid medical disease condition and normal preoperative investigations belong to ASA I & II grade. Patients were observed for block characteristics, hemodynamic, occurrences of side effects and adverse reactions. Results: The regression of the sensory block to S1 dermatome and duration of motor block were affected by the addition of Dexmedetomidine to the spinal bupivacaine. Onset of sensory block at T8 and motor block at bromage 3 were statistically significant between group A and group B. Intraoperative no significant differences in mean systolic BP and diastolic BP between two groups, maximum lowering in heart rate occurred in group B. Conclusion- Dexmedetomidine a newer Alpha 2 agonist seems to be an attractive adjuvant to spinal Bupivacaine even in doses as low as 5 μg. Dexmeditomedine provides longer duration of sensory and motor block without increasing the incidence of significant adverse effects. It provides prolonged sensory and motor blockade, haemodynamic stability, and excellent intraoperative analgesia.