Comparative Study Between Dexmedetomidine And Morphine as Adjuvants to Bupivacaine in Spinal Anesthesia.

Document Type : Original Article

Authors

1 faculty of medicine ,sohag university

2 Department of anesthesia and ICU,Sohag University, sohag,Egypt

3 department of anesthesia, intensive care, and pain management faculty of medicinem sohag university

Abstract

Aim: Inrathecal opioids like morphine added to local anaesthetic agents have been found to be effective in achieving prolonged post-operative analgesia. Intrathecal dexmedetomidine may be devoid of undesirable side effects related to morphine and hence, this study was designed to evaluate analgesic efficacy, haemodynamic stability and adverse effects of both these adjuvants in patients undergoing lower abdominal surgeries.
Methods:
This was a prospective, randomised, double blind study involving 30 patients in each group. Group A received 15 mg of 0.5% hyperbaric bupivacaine with 250 μg of morphine while Group B received 15 mg of 0.5% hyperbaric bupivacaine with 5 μg of dexmedetomidine. Characteristics of spinal block, time for first rescue analgesic and total dose of rescue analgesics were noted. Vital parameters and adverse effects were noted perioperatively. Data analysis was done with independent two sample t-test..Results:
Time for first rescue analgesic (P = 0.19) and total analgesic demand( p value=0.23) were similar in both groups. Duration of sensory (P = 0.001) and motor (P = 000) block was significantly higher in dexmedetomidine group.Itching was noticed in 43% ,nausea in 27% and vomiting in 44% of patients in the morphine group but no itching in dexametomedine group was recorded ,nausea 20% and vomiting 40% of patients in dexametomedine group.
. Conclusion : Intrathecal dexmedetomidine produces prolonged motor and sensory blockade without undesirable side effect.

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