The Effect Of The Intravenous DexmedetomidineOn The Duration Of Sensory And Motor Blockade After Subarachnoid Block


  • Asaad HialYazze


neuraxial anesthesia, dexmedetomidine, bupivacaine


Background:Spinal block, a known technique to obtain anaesthesia for infra umbilical surgeries. Now physician have advantage of using adjuvant to prolong the effect of intrathecal block, which can be given either intravenously or intrathecally, dexmedetomidine is one of them. We studied effect of intravenous dexmedetomidine for prolongation of duration of intrathecal block of 0.5% bupivacaine block.  Aim:To evaluate the effect of intravenous dexmedetomidine on sensory and motor blockade duration after subarachnoid block (SAB) with bupivacaine 0.5% . Methods:a prospective ,randomized ,double blind ,placebo controlled study was carried out in general surgical operation theaters of Baghdad teaching hospital, during the period from 1st March to 30th April 2016Fifty patients of ASA grade I , II are posted for elective infraumblical surgeries were included in the study and randomly allocated into two groups. Group D contain 25 patients received intrathecal 0.5% hyperbaric bupivacaine , followed after 10 minutes by infusion of intravenous dexmedetomidine 1mic/kg in 100 ml normal saline over 10 min. Group (C) contain 25 patients received intrathecal 0.5% hyperbaric bupivacaine 3ml followed after 10 minutes by infusion of same volume of normal saline as placebo . -Person's chi-squre was used to assess statistical association between categorical data. -Analysis of variance(ANOVA) was used to assess the difference between the continuous variables. level of p-value less than 0.05 was significant. Result:.Duration of analgesia in group D was 202.28+_4.46 and in group C was 159.6+_3.12 min. highly significant ( p < 0.0001 ). Duration of motor blockage in group D was 154 .44+_ 7.06 minutes and in group C was 131.04 min. highly significant ( P = < 0.0001 ) Conclusion : Administration of intravenous dexmedetomidine 10 min. after SAB ( infusion of 1mcg/kg over 10 min. ) prolongs the duration of sensory and motor block.


- Richard Brull • Alan J.R. Macfarlane • Vincent W.S. Chan.Spinal, Epidural, and Caudal Anesthesia. In:Ronald D. Miller, MD, al.Miller’s Anesthesia.8 th ed.2015 p1966

- John F. Butterworth IV, MD, David C. Mackey, MD, John D. Wasnick, MD, MPH, et al. Morgan & Mikhail’s Clinical Anesthesiology.5th ed. 2013. P947

- John F. Butterworth IV, MD, David C. Mackey, MD, John D. Wasnick, MD, MPH, et al. Morgan & Mikhail’s Clinical Anesthesiology.5th ed. 2013. P 945

- Dyck JB, Maze M, Haack C, Azarnoff DL, Vuorilehto L, Shafer SL. Computer-controlled infusion of intravenous dexmedetomidine hydrochloride in adult human volunteers. Anesthesiology. 1993; 78(5):821-828. -Pharmacology and physiology for anesthesia : foundations and clinical application / [edited by] Hugh C. Hemmings Jr., Talmage D. Egan. Page 157

- Pandharipande PP, Pun BT, Herr DL, et al. Effect of sedation with dexmedetomidinevslorazepam on acute brain dysfunction in mechanically ventilated patients: The MENDS randomized controlled trial. JAMA. 2007;298:2644–2653.

Riker RR, Shehabi Y, Bokesch PM, et al. Dexmedetomidinevs midazolam forsedation of critically ill patients: A randomized trial. JAMA. 2009;301:489–499.

-Hindle A. Intrathecal opioids in the management of acute postoperative pain. Continuing Education in Anaesthesia, Critical Care & Pain. 2008; 8: 81-85

-McDonnell N, Keating M, Muchatuta N, Pavy T, Paech M. Analgesia after caesarean delivery. Anaesthesia and Intensive Care. 2009; 37: 539-51

-Van de Velde M, Berends N, Kumar A, Devroe S, Devlieger R, Vandermeersch E, De Buck F. Effects of epidural clonidine and neostigmine following intrathecallabour analgesia: a randomised, double-blind, placebo-controlled trial. International Journal of Obstetric Anesthesia. 2009: 3: 207-214 . ANAESTHESIA TUTORIAL OF THE WEEK 230 .

-. Philipp M, Brede M, Hein L. Physiological significance of alpha (2)-adrenergic receptor subtype diversity: one receptor is not enough. Am J PhysiolRegulIntegr Comp Physiol. 2002; 283: R287-295.

-. Ishii H, Kohno T, Yamakura T, Ikoma M, Baba H. Action of dexmedetomidine on the substantiagelatinosa neurons of the rat spinal cord. Eur J Neurosci. 2008; 27: 3182-3190. )

(11. Abdallah FW, Abrishami A, Brull R. The facilitatory effects of intravenous dexmedetomidine on the duration of spinal anesthesia: a systematic review and meta-analysis. AnesthAnalg. 2013; 117: 271- 278.)

- Abdallah, Faraj W. MD*; Abrishami, Amir MD†; Brull, Richard MD, FRCPC‡Anesthesia& Analgesia: July 2013 - Volume 117 - Issue 1 - p 271–278 The Facilitatory Effects of Intravenous Dexmedetomidine on the Duration of Spinal Anesthesia: A Systematic Review and Meta-Analysis .

- (Chilkunda N. Dinesh, N.A. SaiTej, BevinaguddaiahYatish, Vinayak S. Pujari, R.M. Mohan Kumar, and Chadalawada V.R. Mohan ) Saudi j Anesthesia 2014 April-jun.

- D Devika Rani, BhavanaYalamuru, K Sudheesh, and SS Nethra) indian j anesthesia 2013 may –jun. 57

- JyotsnaKubre et al. study (24) , (, Ashish Sethi,1Mamta Mahobia,1Deeksha Bindal,2Neeraj Narang,1 and AnudeepSaxena) Anesthesia Essays Res. 2016 May – Aug. 10 (2)