The impact of different doses of intrathecal dexmedetomidine used as adjuvant to hyperbaric prilocaine in short ambulatory procedures under spinal anesthesia: a randomized controlled study | [Anaesthesia, Pain and Intensive Care • 2024]

Author(s):

1. Eslam Gamal Biekhet: Department of Anesthesiology, Surgical ICU & Pain Management, Armed Forces College of Medicine,Cairo,Egypt:

2. Hesham Elazzazi: Department of Anesthesiology, Surgical ICU & Pain Management, Armed Forces College of Medicine / Faculty of Medicine, Ain-Shams University,Cairo,Egypt:

3. Wael Hussein: Department of Anesthesiology, Surgical ICU & Pain Management, Armed Forces College of Medicine,Cairo,Egypt:

4. Mohamed Zedan: Department of Anesthesiology, Surgical ICU & Pain Management, Armed Forces College of Medicine,Cairo,Egypt:

5. Bassant Mohamed Abdelhamid: Department of Anesthesiology, Surgical ICU & Pain Management, Armed Forces College of Medicine,Cairo,Egypt

Abstract:

Objective: This study aimed to determine the most effective dose of dexmedetomidine as an adjuvant to prilocaine in spinal anesthesia. Methods: Sixty-nine adult patients (21 to 65 y) scheduled for elective surgeries under spinal anesthesia were included in the study. Patients received spinal anesthesia with 3 mL of prilocaine and 0.5 mL dexmedetomidine of dose according to randomization of 5,10 and15 µg (D5, D10 and D15 respectively). Time of the first request of analgesia was set as a primary outcome. Results: Time of the first request of rescue opioid was significantly shorter in D5 group (8 ± 6 h) compared to D15group (21 ± 4 h) (P < 0.018). 24 h of postoperative Nalbuphine consumption was higher in D5 group (4.67 ± 0.59 mg) compared to D15 group (2.5 ± 0.71 mg) (P = 0.012). The onset of sensory and motor blocks was significantly earlier in group D15 and D10 compared to group D5. Group D15 showed a significantly prolonged duration of sensory and motor blockade than Groups D10 and D5. The duration of sensory and motor blockade was significantly prolonged in group D10 compared with group D5 (P < 0.001). Conclusion: 10 and 15 µg dexmedetomidine as an adjuvant to prilocaine in spinal anesthesia shortened the onset of both sensory and motor block, prolonged the duration of sensory block, motor block, and the time to first analgesic. Clinical trial registration: The study was registered on Pan African Clinical Trial Registry (www.pactr.org) (ID: PACTR202204558879194-April 2022).

Page(s): 664-672

DOI: 10.35975/apic.v28i4.2509

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 28, Issue: 4, Year: 2024

Keywords:

Spinal anesthesia , Ambulatory surgery , Intrathecal Dexmedetomidine , Hyperbaric prilocaine

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