European Journal of Cardiovascular Medicine

Background: Bupivacaine is a pipecoloxylidide derivative developed by Ekenstam in 1957 and first utilized in clinical practice in 1963. It is a racemic mixture of the D and L isomers. (2) (3) Bupivacaine is used for procedures that last 2 to 2.5 hours. For longer procedures it may be necessary to convert to general anaesthesia or augment with an intravenous anaesthetic drug. Objectives: The main aim of this study was to see how intravenous dexmedetomidine affected infraumbilical operations done under spinal anaesthesia with hyperbaric bupivacaine 0.5% to observe 1. duration of sensory block, 2. duration of two-segment regression, 3. duration of motor block, 4. intraoperative hemodynamic stability, 5. sedation score, 6. duration of postoperative analgesia and 7. side effects Material & Methods:  Study Design:A prospective, randomized, comparative study. Study area: Department of Anaesthesia, and Critical care, Government Medical college ,Srikakulam ,AP. Study Period: 1 year.  Study population: Adult patients of either   sex, aged between 18-55 years belonging to ASA class I and II without any severe co morbid diseases scheduled for elective infra umbilical surgeries. Sample size: study consisted a total of 100 cases. Study tools and Data collection procedure: A hundred patients undergoing infraumbilical surgeries under spinal anaesthesia were randomly divided into two groups of fifty each using a computer-generated random list. Group D patients got dexmedetomidine infusions of 1 mcg/kg over 10 minutes and subsequently 0.5 mcg/kg/hr until the completion of the surgery, while Group C patients (placebo control) had a similar ratio of normal saline infusion. Results: The median sensory block duration of the dexmedetomidine group was 207.60 (+21.001) minutes, two-segment regression time was 126.10 (+17.65) minutes and median motor block duration was 164.10 (+27.732) minutes. Median sensory block duration was 177.10 (+15.587) minutes in the control group median two-segment regression was 110.80 (+10.418) minutes and motor block duration were 150.40 (+15.937) minutes.Dexmedetomidine group had significantly prolonged sensory block (p < 0.0001) and two-segment regression (P = 0.001) when evaluated to control group. Conclusion: It can be concluded from the present study that Intravenous dexmedetomidine exacerbates the motor and sensory blockage induced by spinal anaesthesia. The risk of bradycardia is considerably raised when IV dexmedetomidine is used as an adjuvant to bupivacaine in spinal anaesthesia.