Thesis on intrathecal dexmedetomidine
However, sometimes it may not provide an adequate level of sensory block. All three treatments had lower side effects with no difference between groups. The sensory block was evaluated with a needle or pinprick every one minute after anesthesia while the motor block was done using Bromage scale, every 5 minutes.
The investigators recorded the peak sensory block level, time to peak block level from intrathecal injection, blood pressure and heart rate, and analgesic supplementation during operation.
In this study we intended to see if a lower dose might provide sufficient and acceptable duration of block and analgesia, as well as less complications. They stated that increasing the dose of dexmedetomidine prolongs the duration of the sensory-motor block and decreases analgesic use.
Gupta [ 19 ] reported that increasing the dose of dexmedetomidine from 2. Intention-to-treat approach was used to analyze the data.
Other studies have also mentioned lower time to reach the highest sensory level in dexmedetomidine compared to fentanyl [ 12 — 19 ]. Kanazi et al.
Thesis on intrathecal dexmedetomidine
And Al-Mustafa et al. The mechanism of how dexmedetomidine prolongs sensory and motor blockade is not known. Outcomes The current review will consider studies that include the following outcome measures: assessment of pain as exhibited by single-dimension pain scales or postoperative analgesia duration time to first analgesic requirement. The difference in hemodynamic findings could be due to the response of each individual to the drug, demographic profile, volume of IT injectate and volume of diluent used. Sedation was assessed by Ramsay sedation scale. In case of any side effects it was recorded. Once demographic data were recorded, two IV lines were placed in different areas, first to administrate the adjuvants studied, and second to use for serum and other drugs. Via intrathecal approach, the patients received 2. Bradycardia was defined as heart rate HR below 50 pulses per minute and if occurred, 0. While Yektas [ 13 ] and Ravipati [ 15 ] reported faster onset of motor block for dexmedetomidine compared to fentanyl. Outcomes After AS, patients were placed in a supine position, and MAP, HR, and oxygen saturation SaO2 were recorded in the three groups at the first 15 minutes and then every 15 to minutes at recovery by anesthesia resident. DMT group received hyperbaric bupivacaine 0. The resident anesthesiologist recorded pain scores using visual analog scale VAS at recovery and 2, 4, 6, and 12 hours postoperatively: 0 is the lowest, and 10 is the highest.
Table 4 Side effects between groups Full size table Discussion In this study, we evaluated the efficacy of three spinal anesthesia methods, bupivacaine alone or with dexmedetomidine or fentanyl in lower limb orthopedic surgeries. IRCTN12 at Reduced need for analgesics in the post-operation period, more stable hemodynamics, longer duration of sensory and motor block for dexmedetomidine have been reported in previous studies comparing this drug with other drugs such as clonidine, fentanyl and sufentanil [ 161921222324 ].
The search found one systematic review published in by Wu et al. Patients were randomly allocated to DXM group or Saline group.
Intrathecal dexmedetomidine with bupivacaine
This difference in adverse effects between three groups was statistically significant. Exclusion criteria included failure in SA and patient dissatisfaction. Side effects may occur by using any anesthesia medications. Dexmedetomidine has been widely used for anesthesia and analgesic purposes. Asano et al. The search found one systematic review published in by Wu et al. The ASA physical status classification is a preoperative assessment used to determine the patient's anesthetic risk based on the patient's overall health. This difference in mean duration of sensory onset between three groups was statistically significant. It means that there is a significant interaction between time and group. Studies published from to present will be considered for inclusion in this review, as was the year that human subject testing began using dexmedetomidine. Hence, we undertook this study to evaluate and compare the effect of adding clonidine versus dexmedetomidine with hyperbaric 0. A study of Anderson et al. In our previous study, low-dose diluted bupivacaine 5 mg provided sufficient anesthetic level when opioid was added with local anesthetic. Decline in HR and blood pressure are common effects of opioids.
based on 44 review