Comparison of Efficacy of Intrathecal Addition of Dexmedetomidine and 0.5% Levobupivacine Heavy with 0.5% Levobupivacine alone in Infra Umbilical Surgeries

Abstract

Background: Intrathecal α2 agonists lessen the dosage needed while extending the duration of action of local anaesthetics. As an α2 receptor agonist, dexmedetomidine has eight times more α2/α1 selectivity than clonidine.

Aim: To compare the efficacy of intrathecal addition of dexmedetomidine to 0.5% levobupivacaine heavy with 0.5% levobupivacaine heavy alone in infraumbilical surgeries. Methods: This was a prospective, randomized, double-blinded clinical study. Patients were randomized into two groups. Group L (n=41) patients received 3ml (15mg) of 0.5% levobupivacaine with 0.1ml of normal saline. Group LD (n=41) patients received 3ml (15mg) of 0.5% levobupivacaine with 0.1ml (10mcg) dexmedetomidine. The onset time and duration of sensory and motor blocks, as well as the time to two-segment sensory regression and the time to first rescue analgesia, were recorded. Adverse effects were also monitored.

Results: Sensory and motor block onset times were significantly shorter in Group LD than in Group L (p<0.000). The regression of the sensory block to L1 dermatome and Bromage 0, as well as the duration of the two-dermatome regression, were significantly longer in Group LD than in Group L (p<0.000). There was no statistically significant difference between the groups when adverse effects were compared.

Conclusion: We conclude that the intrathecal addition of dexmedetomidine to levobupivacaine for spinal anaesthesia results in the rapid onset of sensory and motor blockade with a prolonged duration of postoperative analgesia without significant adverse effects.