A Comparative Evaluation of Intravenous Dexmedetomidine and Clonidine as Premedic Ation for Prolongation of Bupiva Caine Subarachnoid Block for Lower Limb Orthopaedic Surgery
Year: 2015
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: BACKGROUND: Addition of α2 adrenergic agonists with local anaesthetics in bupivacaine spinal anaesthesia prolongs the duration of sensory and motor blockade and postoperative analgesia with minimal haemodynamic alterations.AIM AND OBJECTIVES: To compare and evaluate the efficacy of intravenous dexmedetomidine and clonidine as premedication on subarachnoid blockade duration, postoperative analgesia, and sedation score in patients undergoing lower limb orthopaedic surgeries in bupivacaine (0.5%) heavy intrathecal block. MATERIALS AND METHODS:We carried out a prospective, randomized, double blind study in which 60 patients of ASA status I or II, scheduled for orthopaedic lower limb surgery under spinal anaesthesia, were randomly allocated into two groups of 30 each group A and group B. Group A received dexmedetomidine 0.5µg/kg IV and group B received clonidine 1µg/kg in 10 ml of normal saline intravenously as premedication over 10 min., before subarachnoid blockade with 3.0 ml. of 0.5% hyperbaric bupivacaine.Onset time and regression times of both sensory and motor blockade, haemodynamic parameters were recorded.Duration of postoperative analgesia and sedation score with adverse effects were also recorded.RESULTS: The sensory block level was higher (T5-T7) and earlier in onset (1.81±1.75min.) in dexmedetomidine group than clonidine with level (T6-T8) and onset (2.56±1.62min.).Dexmedetomidine also increased the onset (3.54±3.07min.)and duration (265.45±41.50min.) of motor block achieved as compared to clonidine.The Ramsay sedation score was also greater in dexmedetomidine group than clonidine group (P<0.0001).CONCLUSION: Single dose of premedication with intravenous dexmedetomidine is better than intravenous clonidine during bupivacaine spinal anaesthesia in orthopaedic lower limb surgeries for prolongation of sensory and motor blockade.
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2605146325