Keywords : Buprenorphine
Comparative effects of Dexmedetomidine and Buprenorphine as adjuvants to Bupivacaine in Spinal Anaesthesia
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 8, Pages 3287-3295
Background and Objectives: Addition of adjuvants to local anaesthetics during spinal anaesthesia to prolong the duration of analgesia has been practised for many years. While opioids are the most commonly employed adjuvants, α2 agonists like dexmedetomidine are becoming popular in this regard. We conducted a study to compare the efficacy of dexmedetomidine and buprenorphine as intrathecal adjuvants to 0.5% hyperbaric bupivacaine in terms of prolongation of sensory and motor blockade and duration of analgesia.
Materials and Methods: After obtaining institutional ethics committee approval, a prospective randomized controlled studywas conducted at Saveetha Medical College Hospital. 60 patients posted for lower abdominal surgeries under spinal anesthesia, were randomly divided into two groups of 30 patients in each group. Group D received 5 μg of dexmedetomidine with 3 ml (15mg) of hyperbaric 0.5% bupivacaine; total volume was 3.5ml. Group B received 60μg (0.2ml) of buprenorphine with 3 ml (15mg) of hyperbaric 0.5% bupivacaine; total volume was 3.5ml withthe addition of normal saline. The onset times of sensory and motor block, the time to two segment regression, the durations of sensory block, motor block and analgesia and side effects like sedation, hypotension, bradycardia, nausea and vomiting were recorded.
Results: The two groups were comparable with regard to age,sex, body mass index (BMI) distribution, maximum level of sensory block achieved and onset time of motor block.The duration of analgesia was significantly longer in Group D (349.33± 38.25* minutes in Group D vs 284±22.22* minutes in Group B, * mean± standard deviation ). The onset of sensory block was quicker in Group D and the time to two segment regression, regression to S2 and duration of motor block were also significantly prolonged in Group D. The degree of sedation was significantly higher in Group D while other side effects like
bradycardia, hypotension, nausea and vomiting were not significantly different between the groups.
Conclusion: It can be concluded that 5μg of dexmedetomidine added to intrathecal 0.5% hyperbaric bupivacaine produces longer durations of sensory blockade, motor blockade and analgesia compared to 60 μg of buprenorphine in patients undergoing lower abdominal surgeries.