Comparison of Dexmedetomidine  and Buprenorphine  as an Adjuvant to Bupivacaine during Spinal Anaesthesia for tibial interlocking nailing surgeries

PRADEEP R; AMITHA S

Volume : V, Issue : XI, November - 2016

Comparison of Dexmedetomidine and Buprenorphine as an Adjuvant to Bupivacaine during Spinal Anaesthesia for tibial interlocking nailing surgeries

Pradeep R, Amitha S

Abstract :

Background: Buprenorphine is being used as an adjuvant to local anaesthetic for spinal anaesthesia since long. Dexmedetomidine is a new drug which has got alpha 2 agonistic property, and is being tried for spinal anesthesia along with bupivacaine in recent times. Settings and Design: This study was conducted in a prospective, randomized, controlled and double blind manner. The study included ninety American Society of Anaesthesiologists class I and II patients undergoing tibial interlocking nailing surgeries under spinal anaesthesia. Materials and Methods: The patients were randomly divided into three groups (n=30 each) by closed envelope technique. Patients in group 1 received 15 mg of 0.5% hyperbaric bupivacaine, group 2 received 15 mg of 0.5% hyperbaric bupivacaine with 30�g of buprenorphine, and group 3 received 15 mg of 0.5% hyperbaric bupivacaine with 5�g dexmedetomidine for spinal anesthesia. The duration of motor and sensory blockade and any adverse events were recorded. Data were analysed using Chi-square test or Fisher�s exact test for categorical data and analysis of variance for continuous data. A value of P<0.05 was considered as statistically significant. Results: In our study the subjects in group 3(dexmedetomidine) group had significantly longer period of motor blockade (240�20min) and sensory blockade (180�22.2min) compared to other groups, which is statistically significant (P=0.0001 and P= 0.006 respectively). The time to first request of analgesic in the post-operative period was also longer (240�30.2min) in dexmedetomidine group when compared with other groups (P=0.0001). There were no untoward complications (hypotension, sedation) in any groups. Conclusions: We came to the conclusion that dexmedetomidine (5�g) with bupivacaine for spinal anesthesia gives significantly longer duration of sensory and motor blockade, than buprenorphine (30�g) with bupivacaine for spinal anaesthesia.