Study of Dexmedetomidine as an intrathecal adjuvant to ropivacaine for postoperative analgesia
Journal Title: International Archives of Integrated Medicine - Year 2017, Vol 4, Issue 11
Abstract
Background: Knowledge and use of adjuvant drug therapy has rendered neuraxial analgesia more effective in the management of both acute and chronic pain conditions. α-2 adrenergic agonists have both analgesic and sedative properties when used as adjuvant in regional anaesthesia. Aim: To study the effects of intrathecal dexmedetomidine added to ropivacaine for surgeries under spinal anesthesia. Materials and methods: This clinical study was conducted on 50 patients of ASA PS 1 and 2 in the age group of 18 -50 years of either sex posted for elective lower limb orthopaedic and lower abdominal surgeries under spinal anaesthesia after taking informed consent, study done over a period of 12 months. Results: All demographic details are insignificant. Average duration of surgery was 94.4 min ± 34.4 min. 76% (n= 38) of subjects belonged to ASA grade 1 and 34% (n=12) subjects belonged to ASA grade 2. Mean duration for onset of Sensory block was 4.12 minutes (SD: ± 1.69) and the mean duration for onset of motor block was 10.12 minutes (SD: ± 2.89). Pulse rate in all the patients was maintained in normal range during the observation period. Mean pulse rate was 76 ±4.3 beats per min. average mean systolic pressure was 117.7 ± 14.3 mm Hg and diastolic pressure 68.7± 4.6 mmHg. Mean values of SBP and DBP were maintained in the study population. However, when considered individually, Hypotension was observed in 3 patients after SAB (Fall in SBP > 20%). The hypotension was mainly observed after 4 to 6 min after SAB. The mean Ramsay sedation scale was 2.08 with SD 0.27. Side effects observed were mainly hypotension, nausea and shivering. Conclusion: To conclude, 5 microgram dexmedetomidine seems to be an attractive alternative as an adjuvant to spinal ropivacaine in surgical procedures, especially those requiring long time. This combination (ropivacaine and dexmedetomidine) provides very good quality of haemodynamic stability. It has excellent quality of postoperative analgesia with minimal side effects.
Authors and Affiliations
Tailam Tanmayee, P. Raghunath, D. Anuradha, R. Pandu Naik
Keywords
Related Articles
- EP ID EP412168
- DOI -
- Views 153
- Downloads 0
Our experience with ileocystoplasty for augmentation of tuberculous bladders
Augmentation cystoplasty has traditionally been used in the treatment of low capacity, poorly compliant or contracted bladders. Various bowel segments can be used for augmentation with its own advantages and disadvantage...
A clinical study of post-operative complications of emergency and elective (open and laparoscopic) appendicectomy
Background: Post-operative complications which follows appendicectomy are not common and it reflect the level of peritonitis that is present during the time of surgery and the diseases which may be predisposed to complic...
A study on fluconazole resistance among candida species isolated from patients attending STD OPD in a tertiary care hospital
Back ground: Sexually transmitted infections are a significant public health problem worldwide as they cause widespread morbidity and mortality in both male & female. In developing countries, STI are the third most commo...
Role of Magnetic Resonance Imaging in Evaluation of Epilepsy
Introduction: Seizures have been classified in several ways, according to their etiology, i.e., idiopathic (primary) or symptomatic (secondary); their site of origin; their clinical form (general...
Comparative study of hemoglobin and packed volume levels in term and preterm babies delivered in RMMCH
Background: Most existing accounts of hemoglobin values in healthy premature infants covering the early weeks of life were written before many of the errors of such determinations were recognized. Because of these limita...