International Journal of Medical Anesthesiology
2021, Vol. 4, Issue 1, Part C
A study to evaluate the effect of low dose Intrathecal dexmedetomidine as adjuvant to low dose bupivacaine (H) Spinal Anaesthesia in elderly patients undergoing Infraumbilical Surgery
Author(s): Dr. Nandaraj H, Dr. Kodandaram NS and Dr. Nisarga R
Abstract: Background: Elderly patients pose a serious challenge to anaesthesia not only because of associated co-morbidities but also due to physiological changes during aging. Therefore lower doses of local anesthetics along with Intrathecal a2-adrenoceptor agonists have been shown to decrease the required doses of local anesthetics and are devoid of major side effects. Hence this study evaluates spinal anaesthesia characteristics in elderly patients.
Methods: 120 Patients aged more than 60 years belonging to ASA I,II and III physical status and posted for infraumbilical surgeries were randomized into 2 groups, Group B(Bupivacaine) and Group BD (Bupivacaine + Dexmedetomidine) .Under aseptic conditions lumbar puncture was performed in sitting position at L3-4 / L4-5 interspace and 2.1 ml of study agents were administered. Group B received 10mg of 0.5% hyperbaric Bupivacaine and Group BD received 10mg of 0.5% hyperbaric Bupivacaine and 5mcg of Dexmedetomidine. In all cases monitoring of Blood pressure, ECG, Oxygen saturation and Respiratory rate was done at regular intervals intra-operatively. Sensory block and motor blocks were assessed periodically.
Results: There were no clinically and statistically significant changes in heart rate and blood pressure and the mean max fall in HR, SBP, DBP and MAP. However, it was observed that there was a statistically significant (P<0.001) decrease in the time of onset of sensory block and motor block in Group BD(1.68±0.96 and 2.42±1.12) when compared to Group B(2.24±0.81 and 3.33±1.06) . Duration of analgesia and the time for first rescue analgesia was prolonged in Group BD (P<0.001). There were no side effects except for mild sedation in Group BD.
Conclusion: Addition of Dexmedetomidine 5 mcg to intrathecal Bupivacaine(H) in elderly patients causes minimum hemodynamic changes, prolongs sensory and motor block.
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How to cite this article:
Dr. Nandaraj H, Dr. Kodandaram NS, Dr. Nisarga R. A study to evaluate the effect of low dose Intrathecal dexmedetomidine as adjuvant to low dose bupivacaine (H) Spinal Anaesthesia in elderly patients undergoing Infraumbilical Surgery. Int J Med Anesthesiology 2021;4(1):157-160. DOI: 10.33545/26643766.2021.v4.i1c.215