EVALUATION OF DEXMEDETOMIDINE AS AN ADJUVANT TO SPINAL ANAESTHESIA IN LOWER LIMB SURGERIES: A RANDOMIZED CONTROLLED TRIAL
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Keywords
Dexmedetomidine, Spinal Anesthesia, Bupivacaine, Lower Limb Surgery, Postoperative Analgesia
Abstract
Spinal anesthesia with local anesthetics alone provides limited duration of action and inadequate postoperative analgesia. This study evaluated the efficacy and safety of dexmedetomidine as an adjuvant to hyperbaric bupivacaine in spinal anesthesia for lower limb surgeries.
Methods: This prospective, randomized, double-blind controlled trial was conducted at Gian Sagar Hospital and Medical College, Patiala, from March 2021 to August 2021. A total of 130 patients undergoing elective lower limb surgeries were randomly allocated into two groups. Group C (control, n=65) received 12.5 mg hyperbaric bupivacaine with 0.5 ml normal saline, while Group D (n=65) received 12.5 mg hyperbaric bupivacaine with 5 micrograms dexmedetomidine. Primary outcomes included onset and duration of sensory and motor blockade, duration of analgesia, hemodynamic parameters, and adverse effects.
Results: The dexmedetomidine group demonstrated significantly faster onset of sensory (2.4±0.7 vs 3.8±0.9 minutes, p<0.001) and motor blockade (3.6±0.9 vs 5.2±1.3 minutes, p<0.001). Duration of sensory block (314.8±42.6 vs 186.4±28.7 minutes, p<0.001), motor block (268.7±48.3 vs 164.3±32.4 minutes, p<0.001), and effective analgesia (412.4±54.8 vs 218.6±35.2 minutes, p<0.001) were significantly prolonged in Group D. Hemodynamic stability was maintained with minor reductions in heart rate and blood pressure. Shivering incidence was significantly lower in the dexmedetomidine group (6.2% vs 24.6%, p=0.003). No serious adverse events occurred in either group.
Conclusion: Dexmedetomidine 5 micrograms as an adjuvant to hyperbaric bupivacaine significantly enhances spinal anesthesia characteristics, provides prolonged postoperative analgesia, and maintains an acceptable safety profile for lower limb surgeries.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Dr Prakash Chandra
Assistant Professor, Department of Anesthesiology, Gian Sagar Hospital & Medical College, Patiala, Punjab, India.
