Anesthesia & Clinical Research
Open Access

Abstract

Bupivacaine-Dexmedetomidine for Lumber Discectomy: Randomized Controlled Placebo Study

Abbady A Mohamed, Raafat A Salem and Hesham Refae

Background: Our purpose is to evaluate the efficacy of dexmedetomidine for spine surgery to improve the operative field, the onset and duration of sensory and motor block, the hemodynamic state.

Patients and Methods: Prospective randomized controlled placebo study include 50 patients undergoing lumbar discectomy for herniated disc under spinal anesthesia were randomly divided into two equal groups: Group B (25 patients) received 15 mg (3 ml) of hyperbaric bupivacaine plus 0.5 ml saline to a total volume of 3.5 ml and group D (25 patients) received 15 mg (3 ml) of bupivacaine supplemented with 3 μg of dexmedetomidine in 0.5 ml saline to a total volume 3.5 ml. The onset times to reach peak sensory levels, and the sensory regression times, were recorded. Time to first analgesic rescue, score of operative field, the level of sedation and postoperative complication were also recorded.

Results: Operative field was significantly better in D group (P<0.001). Patients in group D had rapid onset time of sensory block and significantly longer sensory regression time than patients in group B. The time of sensory regression to the S1 segment was 277.76 ± 8.02 min in group D and 239.70 ± 6.83 min in group B (P<0.001). The mean time of sensory regression of two segments was 129.13 ± 5.60 min in group D and 73.66 ± 4.62 min in group B (P<0.001). Highest sensory level was similar in both groups. The mean arterial pressure and heart rate were significantly different in both groups intra-operatively after 20 & 10 minutes respectively from intrathecal injection.

Conclusion: Dexmedetomidine when added to intrathecal bupivacaine improves the operative field, prolong the duration of the sensory block, and improves the quality of postoperative analgesia with minimal side effects with preserved hemodynamic stability and lack of sedation.