The effects of single-dose intravenous dexmedetomidine on hyperbaric bupivacaine spinal anesthesia

Abstract

Single-dose intravenous dexmedetomidine 0.25-0.5 μg/kg, administered 5 min after intrathecal injection of hyperbaric bupivacaine, improved the duration of spinal anesthesia without significant side effects. This method may be useful for increasing the duration of spinal anesthesia, even after intrathecal injection of local anesthetics.

Role of Intravenous Dexmedetomidine in Prolonging Postoperative Analgesia and Quality of Block Following Spinal Anaesthesia. A Systemic Review and Update

“…The timing and dosing method of intravenous dexmedetomidine in spinal anaesthesia varies in different study. Commonly used method of intravenous dexmedetomidine is either as loading dose just before or after spinal anaesthesia [12,[27][28][29][30][31][32], loading dose followed by continuous infusion [11,[33][34][35][36]. Most commonly used loading dose is 0.5 mcg/kg to 1 mcg/kg over 10 min and infusion dose range from 0.2 mcg/kg/hr to 1 mcg/kg/hr [25,26].…”

“…Most of these studies and meta-analysis has shown that intravenous dexmedetomidine given just before or after spinal anaesthesia improved the quality and duration of spinal block [12,[27][28][29][30][31][32][33]. there are many variation in the dosing and method of administration, so it challenging to reliably translate the result into clinical practice.…”

“…Few studies have evaluated the onset time of sensory block after spinal anaesthesia, Readdy et al have compared intravenous dexmedetomidine with clonidine reported that dexmedetomidine shortened onset of sensory-motor block [41] but other studies are not supporting the faster onset of sensory/motor block [12,13,[27][28][29][30]. Few study have reported intravenous dexmedetomidine shortened the onset time by 30-60 sec, which might be clinically significant but it was insignificant statistically [11,33,35].…”

“…Sensory block duration -though there are too much variation in method and dose of intravenous dexmedetomidine and duration of sensory blockadebut most of the studies has reported significantly increased duration of sensory blockade by use of intravenous dexmedetomidine [11][12][13][28][29][30][31][32][33][34][35]37,38,42]. Only one study did not find any difference in block quality with the use of low dose dexmedetomidine infusion that was used solely for the purpose of intraoperative sedation [36].…”

The effects of intravenous dexmedetomidine on spinal anesthesia: comparision of different dose of dexmedetomidine

“…In addition, because it affects the locus ceruleus area, which is associated with the modulation of sleep and respiration, it has a sedative effect with minimal respiratory depression [3,4]. In previous studies, intravenous administration of dexmedetomidine before or after spinal anesthesia prolonged the duration of sensory and motor block [5,6,7,8,9]. Commonly used intravenous methods of dexmedetomidine include a single-dose intravenous administration [5,6,7] before or after spinal anesthesia and a loading dose followed by continuous infusion [8,9].…”