Hyperbaric Bupivacaine Administered as Mixture and Sequentially in Lower Abdominal Procedures

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Hyperbaric Bupivacaine Administered as Mixture and Sequentially in Lower Abdominal Procedures

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Photo by Rob Wicks on Unsplash

Photo by Rob Wicks on Unsplash

Why is it important?

Objectives: To compare the effects of intrathecal dexmedetomidine given mixed or sequential with 0.5% hyperbaric bupivacaine for spinal anaesthesia. Method: 60 patients posted for elective lower abdominal procedures were included in this study. They were randomly divided into two groups. Group M: 30 patients received 5 μg dexmedetomidine intrathecally mixed with 0.5% hyperbaric bupivacaine & group S: 30 patients received 5 μg dexmedetomidine sequentially with 0.5% hyperbaric bupivacaine. Results: The age and weight distribution were comparable in the two groups. The onset of sensory and motor blockade was faster in the sequential group as compared to the mixed group. The degree of sedation was higher in the sequential group. There was a statistical significance among the two groups with respect to duration of post operative analgesia with the sequential group having the longest duration. There was a statistical significant difference in the intraoperative and post operative hemodynamics with the sequential group having a lower systolic and diastolic blood pressure and lower heart rate. There were no significant adverse effects. Conclusion: When dexmedetomidine is given sequentially with 0.5% hyperbaric bupivacaine for spinal anesthesia, it provides early onset of sensory and motor block and prolongs the duration of anesthesia and analgesia. It also provides sedation which is unique to alpha 2 agonists, among which dexmedetomidine provides conscious sedation, with sequential groups demonstrating lower hemodynamic parameters.

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