Comparison of efficacy of intrathecal dexmedetomidine and magnesium sulfate as an adjuvant to 0.5% hyperbaric bupivacaine in patients undergoing infraumbilical surgeries under spinal anesthesia

Background: Adjuvants in spinal anesthesia extends not only the duration of surgical anesthesia but also provides postoperative analgesia. This study aimed at comparing efficacy of intrathecal dexmedetomidine and magnesium sulfate as an adjuvant to 0.5% hyperbaric bupivacaine in various infraumbilic...

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Bibliographic Details
Main Authors: Kavita Jain, Surendra K Sethi, Rahul Jain
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2020-01-01
Series:Journal of Dr. NTR University of Health Sciences
Subjects:
Online Access:http://www.jdrntruhs.org/article.asp?issn=2277-8632;year=2020;volume=9;issue=2;spage=116;epage=123;aulast=Jain
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Summary:Background: Adjuvants in spinal anesthesia extends not only the duration of surgical anesthesia but also provides postoperative analgesia. This study aimed at comparing efficacy of intrathecal dexmedetomidine and magnesium sulfate as an adjuvant to 0.5% hyperbaric bupivacaine in various infraumbilical surgeries. Materials and Methods: 120 patients belonging to American Society of Anesthesiologists (ASA) physical status I or II aged 18 to 65 years of either sex were enrolled and randomly allocated into two groups. Group D (n = 60) received intrathecal bupivacaine (hyperbaric) 0.5%, 12.5 mg (2.5 ml)+dexmedetomidine 5 μg (0.5 ml) while Group M (n = 60) received bupivacaine (hyperbaric) 0.5%, 12.5 mg (2.5 ml) + magnesium sulfate 75 mg (0.5 ml) = 3 ml. Onset of sensory and motor block, time to reach peak level of sensory block, time to two segment regression, duration of sensory and motor block, duration of analgesia, sedation score, hemodynamic changes, and side effects were noted. Results: Onset of sensory and motor block were significantly faster in Group D (2.78 ± 0.34 min and 3.73 ± 0.43 min) compared to Group M (6.47 ± 0.43 min and 7.72 ± 0.48 min); (P < 0.05) Group D (131.70 ± 5.74 min) showed significantly prolonged time to two segment regression compared to Group M (102.78 ± 6.54 min); (P < 0.001). Duration of sensory and motor block were significantly prolonged in Group D (339.75 ± 23.57 min and 314.38 ± 14.93 min) when compared to Group M (248.18 ± 12.89 min and 228.81 ± 11.01 min); (P < 0.05). Duration of analgesia was significantly prolonged in Group D (348.26 ± 22.35 min) than Group M (268.01 ± 11.31 min); (P < 0.001). The patients remained hemodynamically stable in both groups without undue sedation and minimal side effects; (P > 0.05). Conclusion: Dexmedetomidine (5 μg) leads to faster onset as well as prolonged duration of both sensory and motor block, prolonged duration of postoperative analgesia in comparison to magnesium sulfate (75 mg).
ISSN:2277-8632