Dexmedetomidine as an adjuvant to bupivacaine in spinal anaesthesia for hip arthroplasty

Authors

  • V.I. Kolomachenko Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
  • V.S. Fesenko Danylo Halytsky Lviv National Medical University, Lviv, Ukraine

DOI:

https://doi.org/10.22141/2224-0586.16.5.2020.212230

Keywords:

hip arthroplasty, spinal anaesthesia, bupivacaine, dexmedetomidine

Abstract

Background. Spinal anaesthesia is a cost-effective technique for lower extremity surgery. One of its drawbacks is the short duration of postoperative analgesia. The purpose was to find out the effect of adding dexmedetomidine 5 or 10 μg to isobaric bupivacaine 12 mg on block characteristics in patients undergoing elective hip arthroplasty. Materials and methods. Forty-five patients were randomly allocated to three groups, 15 people each: B group (bupivacaine only), BD5 group (bupivacaine and dexmedetomidine 5 μg), and BD10 group (bupivacaine and dexmedetomidine 10 μg). Motor block was assessed pre-operatively and post-operatively using modified Bromage scale. After surgery, time to the first need for systemic analgesia was registered. Results. Before surgery, time to the onset of complete motor block (Me [25 %; 75 %]) in BD10 group (6.5 [5.0; 10] min) was insignificantly shorter than in BD5 group (10.0 [7.0; 15.0] min; p = 0.35) and B group (13.5 [10.0; 15.0] min; p = 0.08). After surgery, time to the onset of partial disappearance of motor block in BD10 group (540 [360; 660] min) was significantly (p < 0.001) longer than in BD5 (330 [300; 420] min) and B (200 [190; 240] min) groups; the difference between BD10 and BD5 groups was significant (p = 0.015), too. Time to the complete disappearance of motor block in BD10 group (630 [420; 720] min) was significantly (p < 0.001) longer than in BD5 (380 [340; 460] min) and B (255 [210; 280] min) groups; the difference between BD10 and BD5 groups was also significant (p = 0.008). Postoperatively, BD10 group showed a longer time to first need for systemic analgesia (720 [600; 860] min) than BD5 group (450 [400; 540] min; p = 0.0014) and B group (285 [230; 300] min; p < 0.001); BD5 group showed a longer time to first need for systemic analgesia than B group (p < 0.001). Conclusions. Addition of dexmedetomidine prolongs both motor block and analgesia from spinal anaesthesia.

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References

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Published

2021-09-30

How to Cite

Kolomachenko, V., & Fesenko, V. (2021). Dexmedetomidine as an adjuvant to bupivacaine in spinal anaesthesia for hip arthroplasty. EMERGENCY MEDICINE, 16(5), 95–99. https://doi.org/10.22141/2224-0586.16.5.2020.212230

Issue

Section

Original Researches