Psychomotor recovery of dexmedetomidine compared with propofol after sedation during spinal anesthesia: A randomized control trial

• Main Authors: Tilak Perika, Suman Lata Gupta, Lenin Babu Elakkumanan, Shivanand Kattimani
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Journal of Anaesthesiology Clinical Pharmacology
• Subjects: Dexmedetomidine; finger tapping test; peg board test; pen and paper test; propofol; psychomotor recovery; visual spatial capacity test
• Online Access: http://www.joacp.org/article.asp?issn=0970-9185;year=2019;volume=35;issue=2;spage=236;epage=241;aulast=Perika

Background and Aims: Early psychomotor recovery is an essential part of day care surgery which depends on brain integration of motor and sensory co-ordination. Even though dexmedetomidine is commonly used for day care procedures, the recovery profile was not studied. Hence, this study was designed to evaluate the psychomotor recovery of sedation with dexmedetomidine during spinal anesthesia. Material and Methods: Sixty-six patients were included. Group D received dexmedetomidine 0.5 μg/kg (loading dose) followed by 0.2–1 μg/kg/hour. Group P received propofol infusion of 25–100 μg/kg/minute. Psychomotor recovery was assessed by finger-tapping, manual dexterity, visual spatial memory capacity, and pen and paper tests. Psychomotor tasks were given to the patients postoperatively at every 30 minutes for 2 hours followed by every hour up to 4 hours after surgery. Distribution of patients, age, weight, duration of surgery, and the level of sensory blockade was compared using independent t-test. Student's t-test has been used to find the significance of parameters such as heart rate, mean arterial pressure, oxygen saturation (SpO2), psychomotor recovery between two groups. P < 0.05 was considered as significant. Results: The motor recovery using finger tapping test was faster in Group D than Group P (73.94 ± 42.13 vs 101.21 ± 37.98 minutes, P–value = 0.007). Motor recovery using peg board test was faster in Group P than Group D (82.12 ± 40.37 vs 99.39 ± 43.08 minutes, P–value = 0.098). Visual spatial capacity memory test and pen and paper test were unaffected. Conclusions: We conclude that patients who received dexmedetomidine showed earlier recovery with finger tapping test. Hence, we suggest to use dexmedetomidine for complete psychomotor recovery and fast-track discharging of the patient after spinal anesthesia.