Authors: Sabu N, Meshram S, Chavan G
Cureus 17(9): e92018. doi:10.7759/cureus.92018
This randomized controlled trial compared low-dose epidural dexmedetomidine combined with 0.0625% bupivacaine (Group BD) against conventional 0.125% bupivacaine alone (Group BB) in 120 ASA I–II adults undergoing abdominal and lower limb surgeries.
Patients in the dexmedetomidine group required fewer rescue analgesics and demonstrated significantly lower pain scores on the visual analog scale (VAS). Hemodynamics were more stable, with modest reductions in heart rate and mean arterial pressure, but without clinical hypotension. Motor block was comparable between groups, and side effects were minimal and controllable.
The findings suggest that adding dexmedetomidine allows for effective analgesia at a lower concentration of bupivacaine, thereby reducing drug load while improving stability and comfort in the postoperative period.
What You Should Know
• Dexmedetomidine as an epidural adjuvant enhances postoperative analgesia compared with bupivacaine alone.
• Lower bupivacaine concentration with dexmedetomidine reduces the need for rescue analgesia.
• Hemodynamic stability is improved without significant hypotension.
• No increase in motor block or major adverse effects was observed.
References
Gupta R, Verma R, Bogra J, et al. A comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to bupivacaine. J Anaesthesiol Clin Pharmacol. 2011, 27:339-343. doi:10.4103/0970-9185.83678
Brummett CM, Hong EK, Janda AM, et al. Perineural dexmedetomidine added to ropivacaine prolongs analgesia by blocking hyperpolarization-activated cation current. Anesthesiology. 2011, 115:836-843. doi:10.1097/ALN.0b013e318221fcc9
Al-Mustafa MM, Abu-Halaweh SA, Aloweidi AS, et al. Effect of dexmedetomidine added to spinal bupivacaine for urological procedures. Saudi Med J. 2009, 30:365-370. PMID: 19271061
Kanazi GE, Aouad MT, Jabbour-Khoury SI, et al. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Anesth Analg. 2006, 103:63-69. doi:10.1213/01.ane.0000221272.26093.4f
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