Assessing the Benefits of Adding Dexmedetomidine to Intrathecal Hyperbaric Bupivacaine for Caesarean Section

Abstract

BACKGROUNDSpinal anaesthesia is the most common and safe anaesthetic procedure performed in parturients for caesarean section. Hyperbaric bupivacaine alone has been used for the last decade for caesarean section. It has rapid onset of action and gives good muscle relaxation & has no adverse effects on foetal APGAR scores. Its limited effects on postoperative analgesia is a matter of concern now a days. Many of the drugs like Tramadol , Butorphanol, Morphine, Fentanyl, Clonidine etc. have been used as an adjuvant to Hyperbaric Bupivacaine in the past; all having their side effects & limitations. Dexmedetomidine is an α -2 adrenoreceptor agonist, benefits of which, when used intrathecally or epidurally as adjuvant, have been proved in many studies. With this background we added 5g of Dexmedetomidine to Hyperbaric Bupivacaine in caesarean section to observe the characteristic of block, post-operative analgesia, sedation and favourable neonatal outcome. METHODSSixty parturients of ASA physical status I & II undergoing caesarean section were assigned to 2 groups (n=30) to receive either 0.5% hyperbaric Bupivacaine 9 mg (1.8 ml) with Dexmedetomidine 5 µ (Group D) or 0.5% hyperbaric Bupivacaine 9 mg (1.8 ml) with saline (Group C). Block characteristics, haemodynamic parameters, sedation scores and neonatal APGAR score were recorded. Data obtained were compiled and analysed with appropriate tests, p-value of ≤ 0.05 was considered significant. RESULTSOnset of sensory and motor block were significantly faster in Group D as compared to Group C. Duration of post-operative analgesia was significantly prolonged in Group D. There was no significant difference in haemodynamic parameters, sedation and neonatal APGAR scores between the groups. CONCLUSIONSThe use of intrathecal 5 µgm Dexmedetomidine as an adjuvant to Bupivacaine for caesarean section produces rapid and prolonged sensory & motor block & allocates better perioperative analgesia without significant maternal and neonatal adverse effects.HOW TO CITE THIS ARTICLE: Royzada B, Kujur S, Royzada A. Assessing the benefits of adding dexmedetomidine to intrathecal hyperbaric bupivacaine for caesarean section.