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THESIS ON INTRATHECAL DEXMEDETOMIDINE

We found that all patients receiving dexmedetomidine had less postoperative pain scores and longer duration of analgesia as compared to control group. Footnotes Source of Support: Open in a separate window. The mean sedation score was 3. Six patients in group C and 3 in group D1 also required tramadol. Patients of American Society of Anaesthesiologists ASA physical status I and II, of either sex, aged between 18 and 60 years, presenting for lower abdominal surgeries were taken.

C, D1, D2, D3 and D4 containing 20 patients. Patients, attending anaesthetists and operating room personnel were not aware of the patient allocations. This effect can be utilized in patients undergoing prolonged surgery and it can be a good alternative to epidural anaesthesia which requires a much higher dose of drug and to general anaesthesia. A randomized prospective study. Monitored anaesthesia care with dexmedetomidine: A follow-up was carried out 1 week postoperatively by the blinded anesthesiologist, who asked about postoperative headache as well as postoperative pain and dysesthesia in the buttock, thighs, or lower limbs. Clonidine as an adjuvant to intrathecal local anesthetics for surgery:

There was no difference in the onset time to Bromage 3 motor block Gupta R et al. In our study, the intrathecal dose of dexmedetomidine selected was based on previous animal studies. Activation of receptors in the brain and spinal cord inhibits neuronal firing and leads to sympatholytic effect, causing hypotension, bradycardia, sedation and analgesia [ 14 ].

Visceral pain during caesarean section under spinal and epidural anaesthesia with bupivacaine. Dexmedetomidine as an intrathecal adjuvant for postoperative analgesia. Author information Copyright and License information Disclaimer. Data regarding the highest dermatome level of sensory blockade, the thsis to reach this level from the time of injection, time to S1 level sensory regression, time to urination, and incidence of side effects were recorded.

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Conclusion Weighing the prolongation of anesthesia and analgesia and side effects we conclude that 10 mcg of dexmedetomidine is optimum intrathecal dose.

A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to Bupivacaine

American Journal of Applired Sciences. Limitation The limitation of our study is that we have considered the analgesic effect of intrathecal dexmedetomidine in healthy patients of ASA I and II. Materials and Methods The study was conducted after approval of ethical committee of the institution.

thesis on intrathecal dexmedetomidine

The mechanical antihyperalgesic effect of intrathecally administered MPV, a novel alpha2- adrenoceptor agonist, in a rat model of postoperative intrathecall. Secondary objectives were to study the characteristics of blocks, the duration of analgesia, the 24 hours analgesic requirement, the highest VRS Score in 24 hours and associated side effects.

Optimal Dose of Intrathecal Dexmedetomidine in Lower Abdominal Surgeries in Average Indian Adult

Open in a separate window. All patients received drug volume of 3ml containing 2. The initial hypertensive phase is due to alpha 2B adrenergic receptors whereas hypotension is mediated by the alpha 2A adrenergic receptors. All the analgesics supplemented were recorded. Dexmedetomidine is a specific and selective alpha 2 intrathecql agonist. The time to rescue analgesic was significantly longer in group D as compared to group F.

A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to Bupivacaine

Brisk response to light glabellar tap or loud noise. After that the patients were placed in supine position for surgery. Patients were randomly divided into the following groups: Bradycardia with Dexmedetomidine is due to postsynaptic intrathecxl of central alpha group 2 adrenoceptors resulting in sympatholytic effect, leading to hypotension and bradycardia, an effect that can be judiciously used to attenuate the stress response of surgery [ 26 ].

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The cause of sedation in higher doses may be due to systemic absorption and vascular redistribution to deexmedetomidine higher centres or cephalad migration in CSF [ 25 ]. Intravenous infusion of diclofenac 75 mg was given, which was repeated after 12 hours, if needed.

thesis on intrathecal dexmedetomidine

The mean highest VRS score along with analgesic requirements were significantly reduced in dexemeditomidine groups, but D3 and D4 had hypotension which needed correction. Data are expressed as either mean and standard deviation or numbers and percentages. Sixty patients classified in American Society of Anesthesiologists classes I and II scheduled for lower abdominal surgeries were studied.

The motor block was assessed using the modified Bromage Scale [ 12 ]. A Clinical Review of Clonidine – Anesthesiology. Responds to commands only. The trend shows that both sensory and motor block onset time and the time for the block to reach T10 or the highest level decreases as the dose of dexmedetomidine increases.

A Double Blind Controlled Study. Block regression was significantly slower with the addition of intrathecal dexmedetomidine as compared with fentanyl, as both time to two segment regressions and time to S2 regression were significantly more with intrathecal dexmedetomidine. J Clin Diagn Res. In absence of satisfactory pain relief with diclofenac, oral tramadol mg was supplemented which could be repeated 4 hourly to a maximum of mg.