EVALUATION OF DEXMEDETOMIDINE AND GLYCERYL TRINITRATE AS HYPOTENSIVE AGENT IN SPINE SURGERIES - A CLINICAL STUDY

Dr Ankur Jain; Dr. Chandrakant; Dr. Krishna kumar Tripathi

Volume : IX, Issue : VII, July - 2020

EVALUATION OF DEXMEDETOMIDINE AND GLYCERYL TRINITRATE AS HYPOTENSIVE AGENT IN SPINE SURGERIES - A CLINICAL STUDY

Dr Ankur Jain, Dr. Chandrakant, Dr. Krishna Kumar Tripathi

Abstract :

Aim:.Induced or controlled hypotension is a method to minimize bleeding during spine surgeries.This study was designed to evaluate the effect of dexmedetomidine(DEX) as hypotensive agent in spine surgeries as compared to glycerytrinitrate(GTN). Subjects and Methods: 60 patients of either sex of ASA grade I or II in the age group of 18-60 years, undergoing spine surgeries were considered for the study and randomly divided into two groups,with 30 each,: (Group I )Dexmedetomidine(DEX) group): was given dexmedetomidine 1 μg/kg over 10 min before induction of anaesthesia followed by 0.2-0.7 μg/kg/h infusion during maintenance. And (Group II) Glyceryl trinitrate(GTN) group :was given Glyceryl trinitrate 3-5 μg/kg/min infusion after induction of anaesthesia. Statistical Analysis Used: Statistical analysis was done using SPSS and Statistical tests employed were Chi-Square (2) Test and Unpaired Student�s t-test. Results: Time of recovery from hypotension was significantly higher in GROUP I . Fall in Hct 2hr postoperatively in patients receiving dexmedetomindine was significantly lesser than patients receiving GTN but there was statistically no significant difference in mean Hematocrit value in groups I &II 24hr postoperatively.The MAP showed a significant reduction in DEX group as compared to GTN group but only at three observation times, that is, after induction of anaesthesia, after intubation and at extubation. There was no significant difference noted between the two groups at rest of observation times. The mean Aldrete score at extubation was significantly higher in DEX group. Mean Ramsey Score[7] was also significantly higher in DEX group 15 minute Postoperatively but 30 and 60 minute postoperatively, we found no significant difference in mean Ramsey Score. Conclusions: Findings of our study conclude that a continuous infusion of Dexmedetomidine is an effective and safe method of producing controlled hypotension in spine surgeries by maintaining better hemodynamics, minimizing blood loss.