Intrathecal Dexmedetomidine Allows Reduction Of The Dose Of Hyperbaric Bupivacaine For Patients Undergoing Lower Limb Orthopedic Surgery: Prospective Case-Control Comparative Study. | ||
| Egyptian Journal of Anaesthesia | ||
| Volume 41, Issue 1, 2025, Pages 1-8 PDF (501.01 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/egja.2025.386326.1088 | ||
| Authors | ||
| Mohamed G Ayaad1; Haitham AM. Osman* 2; Mohsen M. Eissa3 | ||
| 1Department of Anesthesia, Pain and Surgical ICU, Faculty of Medicine, Tanta University, Tanta, Egypt. | ||
| 2Department of Anesthesia, Pain and Surgical ICU, Faculty of Medicine, 2Al-Azhar University, Assiut Branch, Assiut, Egypt. | ||
| 3Department of Anesthesia, Pain & Surgical ICU, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. | ||
| Abstract | ||
| Background: Spinal anesthesia (SA) with rapid sensory and motor blockades and recovery helps to apply same-day surgeries. Intrathecal dexmedetomidine (IT-DEX) as an adjuvant for SA enhances blocks and minimizes the need for postoperative (PO) analgesia. Objectives: To evaluate the outcomes of IT injection of low-dose 0.5% hyperbaric bupivacaine (HBB) with DEX versus the usual dose of plain 0.5% HBB. Patients & Methods: Eighty study patients received 9 mg of HBB 0.5% with 3 µg IT-DEX (Group BD3) or 7 mg of HBB with 5 µg IT-DEX (Group BD5). Another 40 control patients received 12 mg of 0.5% HBB without IT-DEX (Group BD0). The study outcomes included the ability of IT-DEX to reduce the dose of bupivacaine, the DEX dose-dependency of outcomes, the durations of blockade, PO analgesia, and the resultant complications Results: IT-HBB with DEX provided rapid onset and longer block duration than plain HBB. Adding 3 and 5 µg of DEX to IT-HBB allowed reducing its dose by 40% and 53.3%, respectively. The duration of PO analgesia was significantly (P<0.001, =0.033) longer in Group BD5 and BD3, respectively than in Group BD0. Also, the frequency of requesting PO morphine was significantly lower in Groups BD3 (P=0.0001) and BD5 (P<0.001) than in Group BD0. Conclusion IT injection of HBB with DEX reduced the HBB dose, minimized the duration to achieve complete spinal blockade and resolution, and prolonged the duration of PO analgesia. Further, these improvements were DEX dose-dependent and were associated with reduced incidence of SA-induced complications. | ||
| Keywords | ||
| Intrathecal dexmedetomidine; Hyperbaric bupivacaine; Dose-dependency; Durations of the blockade | ||
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