Janaki Babu Kakani1, Shakeela Dasari2
BACKGROUND AND AIMS
There is a dearth of studies on the effect of intravenously administered Dexmedetomidine in Sub Arachnoid Block hence, this study was conducted to compare the effects of intravenously administered Dexmedetomidine prior to the administration of subarachnoid block with bupivacaine 0.5% heavy, on hemodynamic variables and the level and onset and duration of sensory and motor blockade.
MATERIAL AND METHODS
After obtaining ethical Committee approval, a double-blind, randomized prospective clinical study was conducted on 90 American Society of Anesthesiologist Grade I and II patients in the age group of 18-55 years, divided randomly into two groups: Group D received 50 ml solution containing Inj. Dexmedetomidine infusion at 0.5 mcg/kg for 10 minutes, and Group P received 50 ml of solution 0.9% Normal Saline as infusion at 10 minutes time. Subsequently Spinal Anaesthesia is carried out with Bupivacaine heavy 0.5%, and carried out recordings as per protocol. Besides Hemodynamic parameters other parameters observed were effectiveness, Sedation score; highest level of sensory block achieved; Motor and Sensory block; Time for first rescue analgesic requirement were recorded.
RESULTS
Group D (n=45) (Mean±SD) Sedation Score 3.42±0.621 and Group P (n=45) (Mean±SD) Sedation Score 1.80±0.405. Better sedation was seen in Group – D with a p value of less than 0.0001.The highest level of sensory blockade achieved was significantly higher in Group D when compared to the control group, and mean duration (in minutes) to achieve the highest sensory blockade in both the groups: Group D (n=45) (Mean±SD) 7.91±2.42 and Group P (n=45) (Mean±SD) 9.82±3.973 p Value< 0.0001. The highest level of sensory blockade achieved was significantly higher in Group D when compared to the control group, and mean duration (in minutes) to achieve the highest sensory blockade in both the groups. Group D (n=45) (Mean±SD) 7.91±2.42 and Group P(n=45) (Mean±SD) 9.82±3.973 p Value <0.0001. Sensory Block duration in Group D-(n=45) (Mean±SD) 76.18 and in Group P - (n=45) (Mean±SD) 53.44, with p-value = <0.00001. Motor Block duration in Group D- (n=45) (Mean ±SD) 126.42 and in Group P - (n=45) (Mean±SD) 103.64, with p-value= <0.00001.
CONCLUSION
Dexmedetomidine with stablehemodynamic variables, there is significantly prolonged both the sensory and motor block duration with no associated significant changes in the. The level of sensory block attained was significantly higher in the study group and was attained more quickly than the control group. All patients achieved better sedation levels over the entire intraoperative course. It provided good post-operative analgesia with the time to the requirement of the first rescue analgesic being significantly longer.
