Activation of receptors in the brain and spinal cord inhibits neuronal firing and leads to sympatholytic effect, causing hypotension, bradycardia, sedation and analgesia [ 14 ]. Systematic review of randomized trials. Clonidine as an adjuvant to intrathecal local anesthetics for surgery: In our study there were significant increase in the duration of sensory and motor block of spinal anaesthesia and prolonged postoperative analgesia. Sedation was assessed by a modified Ramsay sedation scale. Hence we decided to take a dose of 20 mcg to compare it with 15 mcg of dexmedetomidine to see if this also gives haemodynamic stability and upto what extent it prolongs the analgesic effect of bupivacaine. The duration of analgesia was considered as the period from the injection of the study drug to the first request made by the patient for rescue analgesics.

They found a shorter onset of motor block and a prolongation in the duration of motor and sensory block with haemodynamic stability and lack of sedation [ 5 ]. This article has been cited by other articles in PMC. Sedation was assessed using Ramsay sedation scale [ 13 ] before the block and every 15 minutes. Abdelhamid and El-lakany evaluated the role of dexmedetomidine 5 mcg as adjuvant intrathecally and found it to decrease postoperative analgesic requirement, less shivering among patients of lower abdominal surgery [ 10 ]. Brisk response to light glabellar tap or loud noise. This effect was more pronounced as the dose of dexmedetomidine increased as indicated by the 24 hours analgesic consumption.

HR, mean arterial blood pressure Thesiw and oxygen saturation were monitored and recorded after the block every 5 minutes for 30 minutes; then at 15min upto min and at 30 min interval thereafter. Materials and Methods After getting approval from the Research Ethics and informed consent from adult patients, a randomised controlled, double blinded trial was started. Please review our privacy policy.

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A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to Bupivacaine

Responds to commands intrathecl. Intrathecal dexmedetomidine is associated with prolonged motor and dexmedetomdine block, hemodynamic stability, and reduced demand for rescue analgesics in 24 h as compared to fentanyl.

Postoperatively HR, MAP, Oxygen saturation SpO 2sedation score dexmedefomidine pain score were recorded initially every one hour for 2 hours, then every 2 hour for next 8 hours and then every 4 hour till 24 hours. C, D1, D2, D3 and D4 containing 20 patients. Intrathecally, fentanyl exerts its effect by combining with opioid receptors in the dorsal horn of spinal cord and may have a supraspinal spread and action.

It provides good quality of intraoperative analgesia, hemodynamically stable conditions, minimal side effects, and excellent quality of postoperative analgesia. None of the patients among groups D2, D3 and D4 required tramadol supplementation.

Groups were designed as 2. Many adjuncts like fentanyl, ketamine, tramadol, neostigmine, magnesium sulphate, etc. A Double Blind Controlled Study.

Optimal Dose of Intrathecal Dexmedetomidine in Lower Abdominal Surgeries in Average Indian Adult

Data regarding the highest dermatome level of sensory blockade, the time to reach this level from the time of injection, time to S1 level sensory regression, time to urination, dexmedwtomidine incidence of side effects were recorded. In all cases where dexmedetomidine was used, the fall in BP and heart rate was seen after 30 minutes. Highest level of sensory blockade, the time to reach this level after injection, the time to S1 regression, time to urinate and side effect if any were recorded.

Aim To find out the optimum dose of dexmedetomidine to be used in lower abdomen surgery intrathecally. There was no difference in the onset time to Bromage 3 motor block Antinociception dxmedetomidine epidural and systemic alpha 2 adrenoceptor agonists and their binding affinity in rat spinal cord and brain. Hala E A Eid et al. Murphy Untrathecal, Myors B.

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thesis on intrathecal dexmedetomidine

Characteristics of sensory and motor block of the studied groups minutes. Hence it can be exploited in long duration surgery as an alternative to epidural anaesthesia. With the patient in sitting position, lumbar puncture was performed at L intervertebral space with 25 G pencil point Quinke spinal needle with intrahhecal aseptic precautions.

thesis on intrathecal dexmedetomidine

Alpha sub 2-adrenergic agonists for regional anaesthesia. Abdelhamid and El-lakany evaluated the role of dexmedetomidine 5 mcg as adjuvant intrathecally and found it to decrease postoperative thessis requirement, less shivering among patients of lower abdominal surgery [ 10 ]. Dedmedetomidine were monitored with automated noninvasive blood pressure, pulse oximetry, and electrocardiogram.

The time to rescue analgesic was significantly longer in group D as compared to group F. Dexmedetomidine is a specific and selective alpha 2 adrenoceptor agonist.

A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to Bupivacaine

Many animal studies conducted using intrathecal dexmedetomidine at a dose range of 2. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. Conclusion Weighing the prolongation of anesthesia and analgesia and side effects we conclude that 10 mcg of dexmedetomidine is optimum intrathecal dose.

The effects of Dexmedetomidine and halothane on fos expression in the spinal dorsal horn using a rat postoperative pain model. Find articles by Shagufta Naaz. Nausea and vomiting was o in few patients of C, D2 and D3 and was treated by giving injection ondansetron 8 mg Complete recovery of sensory and motor function was seen in all the patients.