Pharmacokinetics and Pharmacodynamics of Intraspinal Dexmedetomidine in Sheep

Background: Saddle spinal block is the first choice anesthetic technique for adults undergoing peri-anal surgeries. It prevents unnecessary high levels of analgesia and sympathetic block. However, it may not provide prolonged analgesia. This study aims to investigate analgesic effects of dexmedetomidine when added to hyperbaric bupivacaine in saddle spinal block.Methods: Fifty otherwise healthy adults scheduled for uncomplicated peri-anal surgery were randomly allocated into two equal groups in this double-blinded study. Group A received hyperbaric bupivacaine five milligrams; group B received hyperbaric bupivacaine five milligrams plus dexmedetomidine five micrograms intrathecally. Patients remained seated for ten minutes. Time to first analgesic request by patients was the primary end point. Onset and extent of sensory block, and, magnitude and duration of motor block were assessed. Post-operative analgesic consumption and side effects were studied for 24 hours. Student's t-test for quantitative variables and Chi-square test for categorical variables were used for statistical analysis.Results: Patients in group B had a significantly prolonged duration of analgesia (group B, 501 ± 306 minutes; group A, 284 ± 58 minutes) and significantly reduced analgesic requirement than patients in group A. Sensory block in first sacral dermatome appeared significantly earlier in group B. Peak sensory block, magnitude of motor block, and side effects were not significantly different between groups A and B. Conclusions:Dexmedetomidine as an intrathecal adjuvant to hyperbaric bupivacaine in saddle spinal block prolongs duration of analgesia and decreases analgesic requirement with no added side effects.

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“…5 Either additive or synergistic influence of these agents to the effects of local anesthetics may be related to their lipophilicity.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Dexmedetomidine, a selective alpha-2 adrenoceptor agonist, has been used intrathecally for its antinociceptive properties. [5][6][7] But clinical studies evaluating its application in SSB are very sparingly available.…”

mentioning

confidence: 99%

Effects of Adding Intrathecal Dexmedetomidine to Hyperbaric Bupivacaine for Saddle Spinal Block in Adults Undergoing Peri-anal Surgeries

Gautam

Lama

Sharma

2018

J Nepal Health Res Council

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“…There were very few studies done using Dexmedetomidine as an additive in spinal anaesthesia [1] . Eisenach et al [2] had done animal studies with spinal Dexmedetomidine in the dose of 100µg. Kanzai et al [3] did an early human study with 3 µg of Dexmedetomidine and he found it is equipotent to 30µg of Clonidine (1:10 ratio).…”

Section: Discussionmentioning

confidence: 99%

Effect of Dexmeditomidine and Clonidine as Spinal Adjuvant in TURP – A Comparative Study

Logidasan¹

2017

JMSCR

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“…[7][8][9][10] , its use in human studies has also shown promising results in terms of early sensory and motor blocks and enhanced postoperative analgesic effect. [11][12][13][14] On the other hand fentanyl, a lipophilic μ-receptor agonist opioid, is being used as an adjuvant for a long time with no major complications.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study Between Intrathecal Bupivacaine With Dexmedetomidine and Intrathecal Bupivacaine With Fentanyl for Lower Abdominal Surgeries. A Randomized Double Blinded Controlled Clinical Trial

Leelavathy¹,

Iqbal²,

Fathima³

2016

jemds

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BACKGROUNDSpinal anaesthesia is preferred choice of anaesthesia in lower abdominal surgeries since long time. Various adjuvants have been used with local anaesthetics in spinal anaesthesia to provide prolonged postoperative analgesia. Dexmedetomidine, the new highly selective α2-agonist drug, is now being used as a neuraxial adjuvant. This prospective, randomized, double blinded study was conducted to evaluate the onset, duration of sensory and motor blockade, haemodynamic stability and adverse effects of dexmedetomidine and fentanyl when given intrathecally with 0.5% hyperbaric bupivacaine.

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Pharmacokinetics and Pharmacodynamics of Intraspinal Dexmedetomidine in Sheep

Cited by 106 publications

References 0 publications

Effects of Adding Intrathecal Dexmedetomidine to Hyperbaric Bupivacaine for Saddle Spinal Block in Adults Undergoing Peri-anal Surgeries

Effects of Adding Intrathecal Dexmedetomidine to Hyperbaric Bupivacaine for Saddle Spinal Block in Adults Undergoing Peri-anal Surgeries

Effect of Dexmeditomidine and Clonidine as Spinal Adjuvant in TURP – A Comparative Study

Comparative Study Between Intrathecal Bupivacaine With Dexmedetomidine and Intrathecal Bupivacaine With Fentanyl for Lower Abdominal Surgeries. A Randomized Double Blinded Controlled Clinical Trial

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