DOI: 10.36347/sjams.2017.v05i06.046

Pages: 2286-2294

Intrathecal dexmedetomidine is being explored as a new adjunct to bupivacaine for neuraxial anesthesia. Objective is to study variability in various parameters of sensory and motor blockade using different doses of dexmedetomidine intrathecally while reducing the dose of heavy bupivacaine in gynecological surgeries. A unicenter, parallel, double blind randomized prospective controlled trial. 75 females undergoing gynecological procedures, fulfilling the inclusion/exclusion criteria received a total volume of 2.5 ml drug intrathecally, accordingly: D1 (n=25) - hyperbaric bupivacaine 7.5 mg (1.5ml) with 5 μg (1ml) dexmedetomidine. D2 (n=25) - hyperbaric bupivacaine 7.5 mg (1.5ml) with 7.5 μg (1ml)dexmedetomidine. D3 (n=25) - hyperbaric bupivacaine 7.5 mg (1.5ml) with 10 μg (1ml) dexmedetomidine. The outcomes of the study were planned before data collection began. Statistically (p=0.005), onset of T10 level sensory block was dose dependant, fastest in D3 (2.36±0.81 min) and slowest in D1 (3.12±0.83 min) and so was the onset of motor block (p<0.001), time in D3 (2.32±0.63 min) and in D1 (3.56±0.96 min). In peak level, two segment regression time and total time of sensory block, there was no intergroup difference. Dexmedetomidine did effect the total time of motor block, but not in dose dependent pattern (p=0.037). With neurexial dexmedetomidine , onset of sensory and motor block is faster with increasing the dose. Total volume of bupivacaine can be reduced to significant levels to achieve a higher peak level, prolonged two segment regression time and total time of sensory and motor block.