Comparison of Duration of Action in Spinal Anesthesia of 0.5% Bupivacaine and 0.5% Bupivacaine with Dexmedetomidine Spinal Anesthesia: Bupivacaine vs. Bupivacaine with Dexmedetomidine
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Abstract
Background: Spinal anesthesia is a common technique for surgeries below the navel, utilizing bupivacaine, a local anesthetic. Adding adjuncts like dexmedetomidine may enhance the efficacy and duration of the block.
Objective: To compare the duration of action of 0.5% bupivacaine versus 0.5% bupivacaine with dexmedetomidine in spinal anesthesia.
Methods: This quasi-experimental trial included 60 patients aged 20-60 years, ASA grade 1 or 2, undergoing general, plastic, orthopedic, or urological surgery at CMH Karachi. Patients were non-randomly assigned to Group B (0.5% bupivacaine, n=30) or Group BD (0.5% bupivacaine plus 5 mcg dexmedetomidine, n=30). Onset and duration of sensory and motor blocks, duration of analgesia, and adverse effects were recorded. Data were analyzed using SPSS version 25, with a p-value ≤ 0.05 considered significant.
Results: Group BD showed faster onset of sensory block (7.08 ± 0.54 mins vs. 13.48 ± 0.73 mins, p < 0.001) and motor block (10.32 ± 0.91 mins vs. 17.55 ± 0.69 mins, p < 0.001). Duration of motor block was longer in Group BD (284.06 ± 5.64 mins vs. 133.93 ± 5.72 mins, p < 0.001), as was duration of analgesia (218.07 ± 4.86 mins vs. 125.36 ± 5.42 mins, p < 0.001).
Conclusion: The addition of dexmedetomidine to 0.5% bupivacaine significantly enhances the onset and duration of spinal anesthesia with a comparable safety profile.
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References
Cusack B, Buggy DJ. Anaesthesia, Analgesia, and the Surgical Stress Response. BJA Education. 2020;20(9):321-8. doi:10.1016/j.bjae.2020.04.006.
Karunarathna I, Tharayil AS. Unveiling the Potency of Bupivacaine: A Comprehensive Review of Mechanism, Safety, and Clinical Applications. Uva Clinical Lab. 2024.
Chambers WA, Littlewood DG, Edstrom HH, Scott DB. Spinal Anaesthesia with Hyperbaric Bupivacaine: Effects of Concentration and Volume Administered. Br J Anaesth. 1982;54(1):75-80. doi:10.1093/bja/54.1.75.
Ismail AA, Hamza HM, Gado AA. Efficacy of Dexmedetomidine Versus Morphine as an Adjunct to Bupivacaine in Caudal Anesthesia for Pediatric Thoracic Surgeries: A Randomized Controlled Trial. Anesthesiology and Pain Medicine. 2021;11(2). doi:10.5812/aapm.112296.
Liu X, Li Y, Kang L, Wang Q. Recent Advances in the Clinical Value and Potential of Dexmedetomidine. J Inflamm Res. 2021;14:7507-7527. doi:10.2147/JIR.S346089.
Manoharan MM, Paneer M, Elavarasan K, Punniyakoti KK. Dexmedetomidine Versus Clonidine as Additives for Spinal Anesthesia: A Comparative Study. Anesthesiology and Pain Medicine. 2023;13(4). doi:10.5812/aapm-138274.
Chatrath V, Attri JP, Kaur G, Khetarpal R, Bansal P. Comparative Evaluation of Bupivacaine Alone Versus Bupivacaine and Dexmedetomidine for Spinal Anesthesia in Infraumbilical Surgeries. Ain Shams J Anesth. 2015;8(1):83. doi:10.4103/1687-7934.153946.
Liu S, Zhao P, Cui Y, Lu C, Ji M, Liu W, et al. Effect of 5-μg Dose of Dexmedetomidine in Combination with Intrathecal Bupivacaine on Spinal Anesthesia: A Systematic Review and Meta-Analysis. Clin Ther. 2020;42(4):676-90. doi:10.1016/j.clinthera.2020.02.009.
Kumar S, Choudhury B, Varikasuvu SR, Singh H, Kumar S, Lahon J, et al. A Systematic Review and Meta-Analysis of Efficacy and Safety of Dexmedetomidine Combined with Intrathecal Bupivacaine Compared to Placebo. Cureus. 2022;14(12). doi:10.7759/cureus.32425.
Azemati S, Zarghami A, Jouybar R, Naderi-Boldaji V. Analgesic Characteristics of Bupivacaine Alone and in Combination with Dexmedetomidine or Meperidine in Spinal Anesthesia During Cesarean Section: A Double-Blind Randomized Clinical Trial Study. Pain Res Manag. 2022;2022:5111214. doi:10.1155/2022/5111214.
Ahmad MS, Haider SA, Adnan A, Sultan A, Saleemi MS, Khan U. Comparison of Dexmedetomidine Plus Bupivacaine Versus Bupivacaine Alone for Spinal Anesthesia in Patients Undergoing Abdominal Hysterectomy. Pak Armed Forces Med J. doi:10.51253/pafmj.v72i6.4349.
Rehman AU, Siddiq S, Qadeer K, Nawaz A, Hussain K, Ashfaq N, et al. Analgesic Effects of Dexmedetomidine with Hyperbaric Bupivacaine in Spinal Anesthesia for Patients Undergoing Illiazorov Surgery. Anaesth Pain Intensive Care. 2019;23(1):59-62.
Hussain AA, Hussain A, Feroze R, Akram M, Saleem MA, Ali A. Comparison of Bupivacaine and Dexmedetomidine Versus Bupivacaine Alone in Transversus Abdominis Plane Block for Post-Operative Analgesia. J Rawalpindi Med Coll. 2021;25(1). doi:10.37939/jrmc.v25i1.1552.
Owais M, Jan S, Mabood J, Rehman A, Durrani SA, Amin S. Efficacy of Different Doses of Dexmedetomidine as an Adjuvant to Bupivacaine in Sub-Arachnoid Block for Patients Undergoing Lower Limb Surgeries. Int J Health Sci. 2023;7(S1):2810-2818. doi:10.53730/ijhs.v7nS1.14585.
Siddique A, Sadaf S, Ahmad S. Comparison of Bupivacaine Versus Bupivacaine Plus Dexamethasone in Erector Spinae Plane Block for Post-Thoracotomy Analgesia. Med J South Punjab. 2024;5(1):14-20. doi:10.61581/MJSP.VOL05/01/03.
Khaleeq S, Azam M, Siddiq S, Shahid A, Butt Z, Asad N. Comparison of Dexmedetomidine and Dexamethasone as Adjuvant to Bupivacaine in Supraclavicular Brachial Plexus Block. Ann Punjab Med Coll. 2020;14(2):122-5. doi:10.29054/apmc/2020.889.
Marzouk MM, Thabet WR, Ashoor TM, Ahmed AM. Comparative Study Between the Effect of Intrathecal Bupivacaine Versus Bupivacaine Dexmedetomidine Combination in Spinal Anaesthesia for Lower Abdominal Surgeries. QJM. 2021;114. doi:10.1093/qjmed/hcab086.077.
Farooq S, Kousar R, Dilshad R, Munir T, Bashir G, Dilshad A. Comparative Behavior of Two Different Doses of Dexmedetomidine in Intrathecal Anesthesia as an Adjuvant with Hyperbaric Bupivacaine in Elective Caesarian Section. Pak J Med Health Sci. 2021;15(2):288-92.