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Comparative study of intrathecal dexmedetomidine versus intrathecal fentanyl used as adjuvants to bupivacine 0.5% (hyperbaric) in lower abdominal surgeries done in FEU-NRMF Medical Center from November 2013- December 2013 / Rodolfo Astrologio, Jr., Kristine Marie Ilo-Ramos and Abigail C. Luna.

Contributor(s): Language: english Publication details: Fairview, Quezon City: Department of Anesthesiology, FEU-NRMF, 2013.Description: illustrations, tables, photos; (in folder)Content type:
  • text
Media type:
  • unmediated
Carrier type:
  • volume
LOC classification:
  • ANES 2013 0005
Summary: Abstract: Different adjuvants are being used with local anesthetics in spinal anesthesia to avoid intraoperative visceral and somatic pain and to provide prolonged intraoperative and postoperative analgesia. Dexmedetomidine, a highly selective a2-adrenoreceptor agonist, is an approved intravenous sedative and co-analgesic drug which is also a neuraxial adjuvant is gaining popularity. The objective of this study was to evaluate and compare the onset, duration of sensory and motor block, hemodynamic effect, postoperative analgesia and the possible side effects of dexmedetomidine versus fentanyl given intrathecally with hyperbaric 0.5% bupivacaine. The study was conducted in a prospective and double-blinded manner. The study included 60 patients with an American Society of Anesthesiologist (ASA) Physical Status I and II undergoing lower abdominal surgery under spinal anesthesia after approval from the Hospital Ethics Committee with written and informed consent of patients. The patients were randomly allocated into groups (30 patients each). Group A received 3.5 mL volume of 0.5% hyperbaric and 3µg dexmedetomidine in 0.5 mL of normal saline. Group B received 3.5 mL volume of 0.5% hyperberic bupivacaine with 25µg fentanyl. The onset time to reach peak sensory and motor level, regression time of sensory and motor block, hemodynamic changes, side effects and postoperative analgesia were recorded. Patients in Dexmedetomidine Group had significantly longer sensory and motor block times than patients in Fentanyl Group. The regression time of motor block to reach modified Bromage 1, in Dexmedetomidine Group and Fentanyl group, respectively (P< 0.0001). The onset times to reach T6 dermatome and modified Bromage 3 motor block were not significantly different between the groups.Dexmedetomidine group showed significantly less and delayed requirement of rescue analgesic. Intrathecal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability and reduced demand for rescue analgesics in 24 hours compared to fentanyl.
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Research Far Eastern University - Nicanor Reyes Medical Foundation Stock Room ANES 2013 0005 (Browse shelf(Opens below)) Not For Loan draft R000745
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ANES 2013 0002 Difficult airway management in patient with thyroid carcinoma with tracheal luminal extension and narrowing / ANES 2013 0003 Pneumothorax after tracheostomy a case report / ANES 2013 0004 Comparison of the incidence of sore throat in endotracheal tube cuff inflation between negative leak method and pressure regulation method for laparoscopic cholecystectomy patients in FEU-NRMF Medical Center from April 2013 to October 2013 / ANES 2013 0005 Comparative study of intrathecal dexmedetomidine versus intrathecal fentanyl used as adjuvants to bupivacine 0.5% (hyperbaric) in lower abdominal surgeries done in FEU-NRMF Medical Center from November 2013- December 2013 / ANES 2015 0001 A Study on the effect of music as an adjunct for analgesia in post laparoscopic patients in FEU-NRMF mc post anesthesia care unit from April 2013 - October 2013 / ANES 2015 0002 Efficacy of intravenous paracetamol as preemptive analgesia in patients who underwent laparoscopic cholecystectomy / ANES 2015 0003 A Retrospective cohort study on the factors affecting the occurrence of postoperative nausea and vomiting among patients who underwent laparoscopic cholecystectomy under general anesthesia /

Includes bibliographical references and appendices

Abstract: Different adjuvants are being used with local anesthetics in spinal anesthesia to avoid intraoperative visceral and somatic pain and to provide prolonged intraoperative and postoperative analgesia. Dexmedetomidine, a highly selective a2-adrenoreceptor agonist, is an approved intravenous sedative and co-analgesic drug which is also a neuraxial adjuvant is gaining popularity. The objective of this study was to evaluate and compare the onset, duration of sensory and motor block, hemodynamic effect, postoperative analgesia and the possible side effects of dexmedetomidine versus fentanyl given intrathecally with hyperbaric 0.5% bupivacaine. The study was conducted in a prospective and double-blinded manner. The study included 60 patients with an American Society of Anesthesiologist (ASA) Physical Status I and II undergoing lower abdominal surgery under spinal anesthesia after approval from the Hospital Ethics Committee with written and informed consent of patients. The patients were randomly allocated into groups (30 patients each). Group A received 3.5 mL volume of 0.5% hyperbaric and 3µg dexmedetomidine in 0.5 mL of normal saline. Group B received 3.5 mL volume of 0.5% hyperberic bupivacaine with 25µg fentanyl. The onset time to reach peak sensory and motor level, regression time of sensory and motor block, hemodynamic changes, side effects and postoperative analgesia were recorded. Patients in Dexmedetomidine Group had significantly longer sensory and motor block times than patients in Fentanyl Group. The regression time of motor block to reach modified Bromage 1, in Dexmedetomidine Group and Fentanyl group, respectively (P< 0.0001). The onset times to reach T6 dermatome and modified Bromage 3 motor block were not significantly different between the groups.Dexmedetomidine group showed significantly less and delayed requirement of rescue analgesic. Intrathecal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability and reduced demand for rescue analgesics in 24 hours compared to fentanyl.

Research - Department of Anesthesiology

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