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Isobaric ropivacaine with or without dexmedetomidine for surgery of neck femur fracture under subarachnoid block
BACKGROUND AND AIMS: Dexmedetomidine has a promising role as an intrathecal adjuvant. However it's role as an adjuvant to ropivacaine has not been evaluated extensively. This study is designed to find out the effect of addition of dexmedetomidine 5 μg to isobaric ropivacaine 18.75 mg on block c...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360896/ https://www.ncbi.nlm.nih.gov/pubmed/30774234 http://dx.doi.org/10.4103/joacp.JOACP_226_18 |
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author | Dolma, Lhamo Salhotra, Rashmi Rautela, Rajesh S. Banerjee, Ashim |
author_facet | Dolma, Lhamo Salhotra, Rashmi Rautela, Rajesh S. Banerjee, Ashim |
author_sort | Dolma, Lhamo |
collection | PubMed |
description | BACKGROUND AND AIMS: Dexmedetomidine has a promising role as an intrathecal adjuvant. However it's role as an adjuvant to ropivacaine has not been evaluated extensively. This study is designed to find out the effect of addition of dexmedetomidine 5 μg to isobaric ropivacaine 18.75 mg on block characteristics and hemodynamic parameters in patients undergoing surgeries for fracture neck of femur under subarachnoid block (SAB). MATERIAL AND METHODS: Sixty-one American Society of Anesthesiologists (ASA) Class I or II patients between 18–60 years undergoing surgeries for fracture neck of femur under SAB were recruited and randomized into two groups. Thirty patients in Group RN received 2.5 ml isobaric ropivacaine 0.75% (18.75 mg) with 0.5 ml normal saline (NS) to make a total volume of 3 ml, while 31 patients in Group RD received 2.5 ml isobaric ropivacaine 0.75% with dexmedetomidine 5 μg diluted with NS to make a total volume of 3 ml. The block characteristics, hemodynamic parameters, and side effects were recorded in both the groups. RESULTS: Patients in Group RD had significantly longer duration of sensory block (202.90 ± 50.2 min) compared to Group RN (157.33 ± 31.6 min), P < 0.001. Time to first rescue analgesia request was significantly longer in the Group RD compared to Group RN (265.16 ± 71.4 min vs 203.67 ± 35.6 min, respectively) (P < 0.001). However, the sensory block onset, maximum block height, time to two dermatomal regression, and motor block intensity remained unaltered. Incidence of side effects like hypotension, bradycardia, nausea, vomiting, and shivering were statistically similar in both the groups. CONCLUSION: Addition of 5 μg dexmedetomidine enhances the analgesic effect of intrathecal 18.75 mg isobaric ropivacaine for the conduct of fracture neck of femur surgeries with minimal adverse events. |
format | Online Article Text |
id | pubmed-6360896 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-63608962019-02-17 Isobaric ropivacaine with or without dexmedetomidine for surgery of neck femur fracture under subarachnoid block Dolma, Lhamo Salhotra, Rashmi Rautela, Rajesh S. Banerjee, Ashim J Anaesthesiol Clin Pharmacol Original Article BACKGROUND AND AIMS: Dexmedetomidine has a promising role as an intrathecal adjuvant. However it's role as an adjuvant to ropivacaine has not been evaluated extensively. This study is designed to find out the effect of addition of dexmedetomidine 5 μg to isobaric ropivacaine 18.75 mg on block characteristics and hemodynamic parameters in patients undergoing surgeries for fracture neck of femur under subarachnoid block (SAB). MATERIAL AND METHODS: Sixty-one American Society of Anesthesiologists (ASA) Class I or II patients between 18–60 years undergoing surgeries for fracture neck of femur under SAB were recruited and randomized into two groups. Thirty patients in Group RN received 2.5 ml isobaric ropivacaine 0.75% (18.75 mg) with 0.5 ml normal saline (NS) to make a total volume of 3 ml, while 31 patients in Group RD received 2.5 ml isobaric ropivacaine 0.75% with dexmedetomidine 5 μg diluted with NS to make a total volume of 3 ml. The block characteristics, hemodynamic parameters, and side effects were recorded in both the groups. RESULTS: Patients in Group RD had significantly longer duration of sensory block (202.90 ± 50.2 min) compared to Group RN (157.33 ± 31.6 min), P < 0.001. Time to first rescue analgesia request was significantly longer in the Group RD compared to Group RN (265.16 ± 71.4 min vs 203.67 ± 35.6 min, respectively) (P < 0.001). However, the sensory block onset, maximum block height, time to two dermatomal regression, and motor block intensity remained unaltered. Incidence of side effects like hypotension, bradycardia, nausea, vomiting, and shivering were statistically similar in both the groups. CONCLUSION: Addition of 5 μg dexmedetomidine enhances the analgesic effect of intrathecal 18.75 mg isobaric ropivacaine for the conduct of fracture neck of femur surgeries with minimal adverse events. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6360896/ /pubmed/30774234 http://dx.doi.org/10.4103/joacp.JOACP_226_18 Text en Copyright: © 2019 Journal of Anaesthesiology Clinical Pharmacology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Dolma, Lhamo Salhotra, Rashmi Rautela, Rajesh S. Banerjee, Ashim Isobaric ropivacaine with or without dexmedetomidine for surgery of neck femur fracture under subarachnoid block |
title | Isobaric ropivacaine with or without dexmedetomidine for surgery of neck femur fracture under subarachnoid block |
title_full | Isobaric ropivacaine with or without dexmedetomidine for surgery of neck femur fracture under subarachnoid block |
title_fullStr | Isobaric ropivacaine with or without dexmedetomidine for surgery of neck femur fracture under subarachnoid block |
title_full_unstemmed | Isobaric ropivacaine with or without dexmedetomidine for surgery of neck femur fracture under subarachnoid block |
title_short | Isobaric ropivacaine with or without dexmedetomidine for surgery of neck femur fracture under subarachnoid block |
title_sort | isobaric ropivacaine with or without dexmedetomidine for surgery of neck femur fracture under subarachnoid block |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360896/ https://www.ncbi.nlm.nih.gov/pubmed/30774234 http://dx.doi.org/10.4103/joacp.JOACP_226_18 |
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