Dexmedetomidine as Adjuvant to Lower Doses of Intrathecal Bupivacaine for Lower Limb Orthopedic Surgeries.

backgroundDexmedetomidine, an α

aimThe aim of this study is to compare the difference in spinal block characteristics and hemodynamic effects of 7, 8, and 9 mg hyperbaric bupivacaine combined with 5 μg dexmedetomidine and to find out the optimum dose that would provide satisfactory block and hemodynamic stability for lower limb orthopedic surgeries. SETTINGS AND STUDY

designThis was a prospective, observational study. MATERIALS AND

methodsNinety patients undergoing lower limb orthopedic surgeries were allocated to three groups of thirty each. Group A received 7 mg, Group B 8 mg and Group C 9 mg 0.5% hyperbaric bupivacaine along with dexmedetomidine 5 μg. The spinal block characteristics, hemodynamic stability, and side effects were compared. STATISTICAL ANALYSIS: The quantitative variables were compared using ANOVA test and the qualitative variables using Chi-square test.

resultsAll three groups had satisfactory anesthesia and analgesia. The onset of analgesia was slower and peak sensory level lower in Group A. The onset of motor block, time to attain peak sensory levels, duration of analgesia, maximum pain scores, and requirement of rescue analgesics were comparable among groups. Duration of motor block and time of regression of sensory level were more in Group C. Hemodynamics and sedation scores were comparable.

conclusionDexmedetomidine with lower doses of bupivacaine produces satisfactory anesthesia without hemodynamic instability. A dose of 7 mg bupivacaine with 5 μg dexmedetomidine may be sufficient for orthopedic surgeries.