April - June 2019

Intrathecal dexmedetomidine’s effect on the requirement of dose of hyperbaric bupivacaine in spinal anesthesia in the caesarean section patients

Poonam M Vaghela, Arpit J Gohel

1 Assistant professor, GMERS Medical college, Gandhinagar
2 Department of Pathology, GCS Hospital Ahmedabad


BACKGROUND AND OBJECTIVES: Regional anaesthesia has become more popular in caesarean deliveries because most of the parturients prefer being awake during child birth. In addition it is a safer method than general anaesthesia. Present study was done with an aim to determine the ED95 of intrathecal hyperbaric bupivacaine with or without Dex as an adjuvant in spinal anaesthesia for caesarean section using an improved up-down sequential allocation method. METHODS: : A total of 90 participants were included in the study. All the participants were of physical class I or II. All the participants were enrolled for elective caesarean section.They were equally divided into two groups. The study solution for the two groups was 0.75% hyperbaric bupivacaine mixed with 5 mcg of Dex (Dex Group ) or saline (Control Group) and was diluted to 3 mL with saline. A volume not greater than 1 mL was extracted using an insulin syringe (1 ml).The primary outcome of this study was successful anaesthesia or unsuccessful anaesthesia. The secondary outcomes of this study were the characteristics of spinal anaesthesia, analgesic duration of spinal anaesthesia and side-effects.RESULTS There was a significant difference in the duration of the sensory block between the Dex group and the Control group.The total requirement of postoperative rescued sufentanil during the first 24 h in the Dex group was less than in the Control. There was no significant difference in the patient satisfaction of analgesia between the two groups (P>0.05). CONCLUSION: Intrathecal 5 mcg dexmedetomidine potentiated hyperbaric bupivacaine antinociception by 31% in spinal anaesthesia for patients undergoing caesarean section and prolonged the spinal analgesia duration without additional side effects.

Keywords: Bupivacaine, Caesarean,regional anaesthesia, Spinal anaesthesia

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