Comparative Study between the Effect of Intrathecal Bupivacaine versus Bupivacaine Dexmedetomidine Combination in Spinal Anaeshtesia for Lower Abdominal Surgeries

Abstract

lpha 2 adrenoceptor agonists are being increasingly used in anesthesia and critical care as they not only decrease sympathetic tone and attenuate the stress responses to anesthesia and surgery; but also cause sedation and analgesia. They are also used as adjuvant during regional anesthesia. Clonidine, which was initially introduced as antihypertensive, is the most commonly used α 2 agonist by anesthesiologists. Dexmedetomidine is the most recent agent in this group approved by FDA in 1999 for use in humans for analgesia and sedation. In this prospective single blind study conducted on 50 patients undergoing elective surgery, we tried to compare the effect of intrathecal addition of dexmedetomidine to bupivacaine on postoperative analgesia in patients undergoing lower abdominal surgeries the summary of our findings are addition of dexmedotomidine intrathecally to local anaesthetics prolongs both sensory and motor block and has antinociceptive action for both visceral and somatic pain by depressing the release of nociceptive C fibers transmission and hyperpolarization of post synaptic dorsal horn cells. The most significant side effects reported about the use of intrathecal α2 adrenoreceptor agonists are bradycardia and hypotension, in present study, these side effects were not significant probably because we used smaller dose of intrathecal Dex which was confirmed by the findings of Kanazi report which also used smaller dose of Dex 3 μg.