DOI: 10.36347/sjams.2022.v10i09.021

Pages: 1547-1552

Introduction: The duration of analgesia produced by local anaesthesia is limited if administered alone. Therefore, supplementation of local anaesthetics with adjuvants helps to improve the efficacy of the sub-arachnoid block, especially in long-duration surgeries like bilateral total knee replacement. The most preferred drugs used are opioids, but due to new drug development like dexmedetomidine has been introduced and proved to be effective adjuvant. Aim: This study was conducted to evaluate and compare the characteristics of subarachnoid blockade and hemodynamic stability. The VAS was used pre-operatively, after intrathecal, immediately post-operatively, and on the basis of the need for rescue analgesia or epidural. Materials and Methods: A total of 150 patients were taken aged between 30-80 years classified as American Society of Anesthesiologists (ASA) undergoing bilateral TKR under neuraxial anaesthesia were included in the study. The patients were randomly allotted to two groups to receive 4.0 mL of 0.5% hyperbaric bupivacaine with 0.2 mL of dexmedetomidine (5 μg) intrathecally (Group D; n = 75) and another group to receive 4.0 mL of 0.5% hyperbaric bupivacaine with 0.2 mL of buprenorphine (60 μg) intrathecally (Group B; n = 75). Results: There was no significant difference between groups regarding demographic characteristics, no significant difference in hemodynamic variables. The motor, sensory, blockade, and time of rescue analgesia were significantly prolonged in Group D compared to Group B. Hence, Group D was far better than Group B in terms of duration of analgesia, time of onset of sensory block, time for maximum levels of sensory block, and modified bromage score. Conclusion: Intrathecal dexmedetomidine, compared to intrathecal buprenorphine, causes prolonged anaesthesia and analgesia with a reduced need for sedation and rescue analgesics. Also, reduced adverse effects are seen with intrathecal dexmedetomidine. Complications with Group D ............