A Randomized Control Study to Compare Intrathecal Dexmedetomidine Used as Adjuvant to Intrathecal Bupivacaine with Intrathecal Bupivacaine Alone in Orthopedic Surgeries

Background: Regional techniques especially Spinal anes-thesia are used in orthopedic surgeries commonly. It has many advantages over general anaesthesia as adequate analgesia in the perioperative period and it has less complications, also, it provides more successful blockade with less failure rate than epidural block. The main disadvantage is the shorter duration of block and lack of postoperative analgesia. One of the means to overcome this drawback is adding an adjuvant to the block so as to speed the onset and prolong the duration of the block, many drugs had been used including clonidine, benzodiazepines and lately dexmedetomidine has been used for this purpose too. Methods: 60 patients, ASA I/II were enrolled into the study. All patients had spinal anesthesia and randomly allocated into one of two groups. Group C: (30 patients): The patient received 15mg of bupivacaine 0.5% plus 0.4ml saline, Group D: (30 patients): The patient received 15mg of bupivacaine 0.5% plus 0.1ml dexmedetomidine (10μg) plus 0.3ml saline. In both groups assessment was done for time to reach T10 dermatome, time to peak sensory level, time to reach complete motor block (Bromage 3), regression to S1 dermatome and time for motor recovery. Results: This study demonstrated that a more rapid onset of action of the spinal block was achieved in the dexmedeto-midine group, with prolonged duration of both sensory and motor recovery. Hemodynamic variables were stable and there were no significant differences between both groups. Conclusion: Finally, it is concluded that Dexmedetomidine (10mcg) is effective as useful adjuvant to the local anesthetic for spinal anesthesia. Dexmedetomidine is associated with a faster onset of action and longer postoperative sensory and motor block. Dexmedetomidine also reduce intraoperative shivering with no significant side effects.