Effects of intrathecal dexmedetomidine versus intravenous dexmedetomidine as a pre-medication on clinical profile of bupivacaine spinal anaesthesia in Lower abdominal surgeries: A RCT

Abstract

Dexmedetomidine is a highly selective α2-adrenoceptor agonist which produces dose-dependent sedation and analgesia without respiratory depression. It prolongs the duration of local anaesthetics by different routes of administration. This study was aimed to compare the effect of intrathecal (IT) versus intravenous (IV) dexmedetomidine on bupivacaine spinal anaesthesia in patients undergoing lower abdominal surgery. This prospective double-blinded randomized controlled study was conducted on 60 patients randomly divided equally into 2 groups. Group A (IT group) (n=30) received 3ml of 0.5% hyperbaric bupivacaine and 10μg of dexmedetomidine intrathecally and Group B (IV group) (n=30) received premedication with IV dexmedetomidine 0.5μg/kg and then 3ml of 0.5% hyperbaric bupivacaine plus 0.1ml of normal saline intrathecally. We observed that in bupivacaine spinal anaesthesia, dexmedetomidine, when administered intrathecally, has greater augmentation to sensory and motor block, more hemodynamic stability, better analgesic properties, and fewer overall side effects as compared to premedication with IV dexmedetomidine.