Table 4
Spinal block characteristics (Highest sensory level, onset and regression time of sensory and motor blocks in minutes), data were expressed as mean ±SD, median and range
Source publication
The aim of this study was to evaluate the effect of addition two different doses of dexmedetomidine or fentanyl to intrathecal hyperbaric bupivacaine on spinal block characteristics, intraoperative hemodynamics, the blood glucose level and postoperative pain. 100 patients ASA I and II, ages 20 -60 years old undergoing elective surgeries below the u...
Context in source publication
Context 1
... regards to intraopeartive mean arterial blood pressure no statistical significant differences between the study groups except at 95 minutes, (Table3). Regarding the spinal block characteristics, no statistical significant differences between the study groups in the highest sensory level, time to reach the maximum sensory level, but time to sensory regression to S1was statistically significant lower in group I compared to the other groups, onset time to modified Bromage 3 was statistically significantly lower in group IV compared to the other groups, regression to modified Bromage 0 was statistically significant lower in group I compared to the other groups (Table 4). doi: 10.5455/medscience.2015.04.8240 www.medicinescience.org ...
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![TABLE 1 ]](profile/Kaushic-Theerth/publication/312577624/figure/tbl1/AS:614316373966869@1523475845439/93_Q320.jpg)
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Citations
... Better degree of analgesia in Group LD seen in our study was due to the synergism of dexmedetomidine and levobupivacaine and effectiveness of dexmedetomidine in abolishing visceral pain. This was in accordance with studies conducted by Kim et al 25 Basuni and Ezz,24 Eid et al26 and Amer et al. 27 ...
Background and Aim: Spinal anesthesia is a widely used technique providing faster onset with effective and uniformly distributed sensory and motor block. Due to decreased cardiovascular and central nervous system toxicity, levobupivacaine is a good alternative for spinal anesthesia. Present study was done to compare the effects of adding of dexmedetomidine to levobupivacaine in prolonging the analgesia produced by epidural levobupivacaine alone in patients undergoing infraumbilical surgeries. Material and Methods: A prospective study was carried out which included 100 adult patients between the age group of 20 and 65 years of physical status American Society of Anesthesiologists Classes I and II who underwent infraumbilical surgeries. Group L patients received 3 ml (15 mg) of 0.5% isobaric levobupivacaine + 0.3 ml normal saline while Group LD patients received 3 ml (15 mg) of 0.5% isobaric levobupivacaine + 0.3 ml (3 μg) dexmedetomidine. The two groups were compared with respect to the onset and duration of sensory and motor block and hemodynamic stability. Results: In Group LD, increase in VAS was observed at 210 min and the first dose of rescue analgesia was given at 5th h postoperatively. The second dose of recue analgesia was given at 12th h and the third dose was given at 21st h. Postoperative VAS scores at different time intervals were significantly lower in Group LD than Group L, thus indicating superior analgesia. The time of request of the first dose of rescue analgesia was delayed in Group LD and the difference in the two groups was highly significant (P < 0.001). Conclusion: Epidural administration of dexmedetomidine with levobupivacaine hydrochloride 0.5% results in faster onset of sensory and motor blockade compared to levobupivacaine hydrochloride 0.5% alone. Dexmedetomidine as an adjuvant to levobupivacaine hydrochloride 0.5% provides superior quality of analgesia without any significant hemodynamic instability.
... In recent years, a number of techniques have been proposed to prolong the duration of this type of anesthesia and improve the quality of the blockade with minimal complications. One of the techniques that can be mentioned is intravenous injection of various drugs or utilization of some drugs such as epinephrine, phenylephrine, opioids, and α2-adrenergic agonists as an adjunct to local anesthetics [4,5]. However, addition of some adjunct drugs can be accompanied with lots of complications including hypotension, bradycardia, shivering, nausea and vomiting, excessive sedation, and itching. ...
PurposeThe aim of this study was to evaluate the quality of spinal anesthesia and hemodynamic parameters of intravenous versus intrathecal dexmedetomidine in patients undergoing inguinal hernia repair surgery under spinal anesthesia.Methods
Fifty male patients aged 18–70 years with ASA I and II were randomly divided into two groups of 25 patients receiving either intravenous (1 μg/kg infused during 10 min before blockade) or intrathecal (5 μg, added to local anesthetics) dexmedetomidine. The duration of analgesia, sensory and motor blockade levels, the score of pain intensity, post-operative analgesic usage and the level of sedation as well as hemodynamic changes, and complications were recorded.ResultsThe duration of analgesia in the intrathecal group was significantly longer than intravenous group (403.588 ± 93.706 vs. 274.048 ± 47.266 min; P < 0.001). Duration of the sensory and motor blockade were significantly longer in intrathecal than intravenous group (230.440 ± 26.494 vs. 181.400 ± 28.850 min; P < 0.001 for sensory block, and 253.800 ± 32.637 vs. 205.400 ± 30.921 min; P < 0.001 for motor block). The score of pain intensity was lower in the intrathecal group in the post-operative period (3.680 ± 1.680 vs. 5.520 ± 1.901; P = 0.001 and 2.360 ± 1.320 vs. 3.24 ± 1.69; P = 0.041, respectively, for the time 6 and 12). Ramsay sedation score was higher in the intravenous group during surgery but it was higher in intrathecal group during recovery room period (P < 0.05). Moreover, the incidence of bradycardia was significantly lower in the intrathecal group (0% vs. 36% respectively; P = 0.002).Conclusion
Administration of intrathecal dexmedetomidine along with local anesthetics can be recommended to increase the quality of spinal anesthesia with minimal complications.
... Better degree of analgesia in Group LD seen in our study was due to the synergism of dexmedetomidine and levobupivacaine and effectiveness of dexmedetomidine in abolishing visceral pain. This was in accordance with studies conducted by Kim et al., [12] Basuni and Ezz, [15] Eid et al., [21] and Amer et al. [22] Hypotension was seen in 10% of patients each in Group L and Group LD and bradycardia was 3% in Group L and 13% in Group LD, and the differences were statistically nonsignificant (P > 0.05) between the two groups (P > 0.05) as observed by Esmaoğlu et al. [14] and Amer et al. [22] conclusIon It is concluded from our study that both the groups were effective in providing surgical anesthesia and hemodynamic stability, but Group LD was better than Group L as regards: • Early onset of sensory and motor block • Prolonged duration of sensory and motor block • Longer duration of postoperative analgesia • Lesser number of doses of rescue analgesia required. ...
... Better degree of analgesia in Group LD seen in our study was due to the synergism of dexmedetomidine and levobupivacaine and effectiveness of dexmedetomidine in abolishing visceral pain. This was in accordance with studies conducted by Kim et al., [12] Basuni and Ezz, [15] Eid et al., [21] and Amer et al. [22] Hypotension was seen in 10% of patients each in Group L and Group LD and bradycardia was 3% in Group L and 13% in Group LD, and the differences were statistically nonsignificant (P > 0.05) between the two groups (P > 0.05) as observed by Esmaoğlu et al. [14] and Amer et al. [22] conclusIon It is concluded from our study that both the groups were effective in providing surgical anesthesia and hemodynamic stability, but Group LD was better than Group L as regards: • Early onset of sensory and motor block • Prolonged duration of sensory and motor block • Longer duration of postoperative analgesia • Lesser number of doses of rescue analgesia required. ...
Introduction
Spinal anesthesia is a widely used technique providing faster onset with effective and uniformly distributed sensory and motor block. Due to decreased cardiovascular and central nervous system toxicity, levobupivacaine is a good alternative for spinal anesthesia. Dexmedetomidine when used intrathecally is associated with prolonged motor and sensory block, hemodynamic stability, and less requirement of rescue analgesia in 24 h.
Materials and Methods
A prospective, randomized study was carried out which included 60 adult patients between the age group of 20 and 65 years of physical status American Society of Anesthesiologists Classes I and II who underwent infraumbilical surgeries. Group L patients received 3 ml (15 mg) of 0.5% isobaric levobupivacaine + 0.3 ml normal saline while Group LD patients received 3 ml (15 mg) of 0.5% isobaric levobupivacaine + 0.3 ml (3 μg) dexmedetomidine. The two groups were compared with respect to the onset and duration of sensory and motor block and hemodynamic stability.
Results
The mean duration of sensory block in Group L was 199.50 ± 7.96 min while in Group LD was 340.20 ± 11.78 min. All the differences were statistically highly significant between the two groups (P < 0.001). Mean duration of motor block in Group L and LD was 150.83 ± 9.17 min and 190.20 ± 9.61 min, respectively. Both the differences were highly significant (P < 0.001).
Conclusion
It is concluded that Group LD has early-onset and prolonged duration of sensory and motor block and longer duration of postoperative analgesia than Group L.
