Online ISSN: 2515-8260

Keywords : subarachnoid block


Comparison of the Effect of Adding Dexmedetomidine versus Midazolam to Intrathecal Bupivacaine on the Post-Operative Analgesia

Dr Ravi Shrivastav, Dr Sachin Kumbhare, Dr Arpit Khandelwal, Dr. Hemant Vanjare

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1225-1232

Background: Dexmedetomidine and midazolam both affects duration of spinal
analgesia by different mechanisms, and yet, no studies are available to compare them
for postoperative analgesia after neuraxial administration. We investigated the addition
of dexmedetomidine or midazolam to intrathecal bupivacaine on the duration of
effective analgesia.
Materials and Methods: The patient posted for elective procedure under spinal
anaesthesia were randomly allocated in to three group of 20 patient and each group.
Group D- Patient in the group receiving 3 ml of 0.5% hyperbaric Bupivacaine with
5mcg Dexmedetomidine the total volume is 3.5ml. Group M - Patient in the group
receiving 3 ml of 0.5% hyperbaric Bupivacaine with 1mg of Midazolam, the total
volume is 3.5 ml. Group B-: Patient in the group receiving 3 ml of 0.5% hyperbaric
Bupivacaine with 0.5 ml of normal saline, the total volume is 3.5 ml. The groups were
compared to the regression time of sensory block, duration of effective sedation score,
and side effects.
Results: The mean duration of sensory and motor block was quite prolonged in group D
patients The results were, statistically highly significant (P<0.0l) There
is significant difference between all the three groups in group D the sensory duration
block is 226 minutes while in group M is 158.7 minutes, In group B this Is 134.8 minutes
which is much less than the above groups. The motor block in group D 202.35 minutes,
in group M is 110.5 minutes and in group B is 96.8 minutes.
Conclusion: Dexmedetomidine (5mcg) when used as an adjunct to 3 ml of 0.5%
hyperbaric bupivacaine and prolongs the duration of effective analgesia in the
immediate postoperative period without any significant hemodynamic instability in
comparison to 1 mg midazolam.

An Observational Study to See the Effect of Intravenous Dexmedetomidine Infusion on the Duration of Subarachnoid Block with Isobaric Ropivacaine in a Tertiary Care Hospital in Raichur

Dr. Sunil S. Kumar, Dr. Prashant Vadigeri, Dr. Achyutha J, Dr. Niranjan C. S

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1876-1883

Background: Choice of anaesthesia for surgery below the umbilicus is Subarachnoid block
with Bupivacaine traditionally. Dexmedetomidine is being used with Ropivacaine to avoid
side effects of Bupivacaine. The objective of this study is to compare the groups (group 1-
only Ropivacaine and group 2- Ropivacaine with Dexmedetomidine) with respect to
duration of sensory block and motor block, sedation, and complications.
Material and Methods: This is a prospective observational study and 30 patients in each
group were included. Duration of sensory block and motor block, scale of sedation and
complications were looked for. Patients with bradycardia, AV block, using beta blockers,
calcium channel blockers or anti-arrhythmic and hepatic or renal dysfunction were
excluded. Mean and standard deviation for continuous variables, frequencies and
percentages for categorial variables were determined. Chi-Square test, Paired T test,
Independent T test or Unpaired Test, and Wilcoxon Sum Rank Test were done.
Results: Mean age and weight of the group-1 were 38.80±4.2years and 62.23±5.43 kg and
that of group-2 were 39.67±5.9 years and 63.45±6.23 kg respectively. Mean duration of
sensory and motor blockade of the group-1 were 189±18.2 minutes and 158±18.77 minutes
respectively and that of group-2 were 230±19.7 minutes and 189±21.34 minutes
respectively (p<0.001). Ramsay sedation scores in the group with only Ropivacaine was 1.7
± 0.3 while in Dexmedetomidine group was 2.4±0.3 (p<0.001). 13 patients experienced
hypotension, 5 were from only Ropivacaine group and 8 were from Dexmedetomidine
group(p<0.001). 12 patients experienced bradycardia among which 4 were from only
Ropivacaine group and 8 from Dexmedetomidine group(p<0.001).
Conclusion: Intravenous dexmedetomidine in patients getting 0.75% isobaric ropivacaine
for subarachnoid block, increases time to two dermatomal regression of sensory blockade,
duration of sensory block, duration of motor block and provides good sedation.