DOI: 10.36347/gamj.2023.v04i01.002

Pages: 6-16

Many adjuvants have been used to improve the duration and quality of anaesthesia and analgesiatill postoperative period. Dexmedetomidine, with its high α2 adrenoceptor agonism, has been found to be a useful adjuvant to intrathecal hyperbaric bupivacaine in prolonging sensory and motor block. Thus using Dexmedetomidine as an adjuvant can reduce local anaesthetic requirment. This study was done to compare two different doses of hyperbaric bupivacaine intrathecally with a fixed dose of dexmedetomidine in an aim to arrive at an optimum dose of hyperbaric bupivacaine with minimum adverse effects that would provide satisfactory block and hemodynamic stability for lower limb orthopedic surgeries. A prospective, non interventional, observational clinical study was carried out on 100 ASA Grade I and II patients of either sex, aged 18-70 years, undergoing various orthopaedic surgeries on the lower limb under subarachnoid block (SAB). The patients were divided into two groups of 50 patients each. Group A patients were received 2ml of 0.5% hyperbaric bupivacaine (10mg) with 5mcg of dexmedetomidine and Group B patients were received 2.5ml of 0.5% hyperbaric bupivacaine (12.5mg) with 5mcg of dexmedetomedine. The study yields statistically significant occurrence of hypotension and delay in motor function recovery in 12.5 mg hyperbaric bupivacaine group although no statistical difference in characteristics of sensory blockade and analgesia. So the study concludes the use of dexmedetomidine could reduce the dose of intrathecal local anaesthetic requirement. A 10 mg dose of hyperbaric bupivacaine with 5 μg dexmedetomidine may be sufficient for lower limb orthopedic surgeries.