Studying the sedative effect of dexmedetomidine administeredby two different routes, a randomized comparative trial

Background Efforts to find a better adjuvant in spinal anesthesia have been underway for a long time to achieve both effective analgesia and targeted sedation. We evaluated whether we can use dexmedetomidine in spinal anesthesia through its multiple modes of action and reduced adverse events in comparison with its intravenous use to achieve desirable patient comfort and sedation. Patients and methodsA total of 100 patients classified as American Society of Anesthesiologists class I and IIscheduled for inguinal hernia repair were studied. Patients were allocated randomly to receive either 15 mg of 0.5% hyperbaric bupivacaine plus 0.5 ml normal saline intrathecally and an intravenous infusion of dexmedetomidine 1 μg/kg over 10 min (group V, n = 50) or 15 mg of 0.5% hyperbaric bupivacaine plus 5 μg of dexmedetomidine diluted in 0.5 ml normal saline intrathecally and an intravenous infusion of same volume normal saline over 10 min (group S, n = 50).ResultsPatients in both groups were comparable in the characteristics of the spinal block and sedation score.ConclusionIntrathecal dexmedetomidine can act both as an adjuvant to bupivacaine and as a sedativewithout the need for other intravenous sedation drugs.