Dexmedetomidine and sodium bicarbonate as adjuvantsto epidural lidocaine: a comparative study

Context Efforts to find a better adjuvant in regional anesthesia have been underway since long. Dexmedetomidine and sodium bicarbonate have been proven to be effective in providing the same pharmacological benefit through two different mechanisms of action. In this study, we sought to investigate which is superior between the two.AimsThe aim of the study was to compare the efficacy of dexmedetomidine and sodium bicarbonate as adjuvants to lidocaine in epidural anesthesia.Settings and designThis was a prospective, randomized, double-blind study.Materials and methodsSixty patients scheduled for lower-limb trauma orthopedic surgeries under epidural anesthesia were divided into two groups group D and group S, with 30 patients in each. Patients in group D received 12.5 ml of 2% lidocaine+dexmedetomidine 0.5 μg/kg in 1.5 ml solution, making a total volume of 14 ml. Patients in group S received 12.5 ml of 2% lidocaine+1.5 ml of 7.5% sodium bicarbonate, making a total volume of 14 ml. Onset, time for peak sensory level, time for two-segment regression, and the total mephentermine consumed to maintain the hemodynamics were recorded, tabulated, and statistically analyzed.ResultsThe onset of sensory block was quicker in group D. The time for attaining peak sensory level and the mephentermine consumption was nearly the same in both groups. The time for two-segment regression was more in group D than in group S.ConclusionDexmedetomidine is more effective than sodium bicarbonate in hastening the onset andprolonging the duration of blockade when used as an adjuvant to epidural lidocaine.