EFFECT OF INTRATHECAL DEXMEDETOMIDINE AS ADDITIVE FOR SUBARACHNOID BLOCK IN ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A PROSPECTIVE RANDOMIZED DOUBLE BLIND STUDY
Dr. Rajesh Kumar Singh, *Dr. Pradeep Brijkishor Sharma, Dr. S Naveen and Dr. H. S. Agrawal
ABSTRACT
Background and Aim: Dexmedetomidine, a highly selective α2 agonist has gained popularity as adjuvant in all modes of regional anaesthesia. We studied the characteristics of subarachnoid block with dexmedetomidine 5mcg added to hyperbaric bupivacaine in arthroscopic anterior cruciate ligament (ACL) reconstruction. Methodology: 50 ASA I & II patients were randomly allocated into two groups of 25 patients each. Group GS received 17.5mg 0.5% hyperbaric bupivacaine with 0.5ml normal saline, GDXM received 17.5mg hyperbaric bupivacaine with 5 mcg dexmedetomidine with normal saline in total 4ml volume. The onset and duration of sensory block, motor block, hemodynamics, postoperative analgesia and side effects were recorded. Results: The mean onset time for the sensory block to reach T8 dermatome and motor block to reach Bromage 3 grade was significantly less in GDXM than GS group. Time to regression of sensory block, motor block and time to rescue analgesia were significantly prolonged by addition of dexmedetomidine. GDXM required less number of rescue analgesic doses. Conclusion: Intrathecal use of dexmedetomidine 5mcg with 0.5% heavy bupivacaine provides a faster onset and prolonged duration of sensory as well as motor block along with prolonged postoperative analgesia.
Keywords: Subarachnoid block, dexmedetomidine, adjuvant.
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