ENHANCING SPINAL ANESTHESIA WITH DEXMEDETOMIDINE: A PROSPECTIVE STUDY ON PROLONGING ANALGESIA AND REDUCING OPIOID REQUIREMENTS IN INFRA UMBILICAL SURGERIES

YASH VIJAY; AKIL HUSSAIN; DEVASHISH SINGH SHEKHAWAT

doi:10.22159/ijcpr.2025v17i1.6028

Authors

YASH VIJAY Department of Anaesthesia, Jhalawar Medical College, India
AKIL HUSSAIN Department of Anaesthesia, Jhalawar Medical College, India
DEVASHISH SINGH SHEKHAWAT Department of Anaesthesia, Jhalawar Medical College, India

DOI:

https://doi.org/10.22159/ijcpr.2025v17i1.6028

Keywords:

Dexmedetomidine, Spinal anesthesia, Pain management, Opioid reduction, Surgical anesthesia

Abstract

Objective: Pain management in surgical settings poses significant challenges, particularly in minimizing opioid use due to associated risks. Dexmedetomidine, a selective α2-adrenergic agonist, has shown promise as an adjunct in spinal anesthesia to enhance analgesic and anesthetic effects.

Methods: This prospective, randomized, double-blind study involved 60 patients undergoing infraumbilical surgeries, divided into two groups. Group D received intravenous dexmedetomidine, while Group C received a saline placebo. We assessed the duration of sensory and motor blocks, sedation levels, and the time to first postoperative analgesia request.

Results: Group D exhibited significantly longer durations of sensory and motor blocks, higher sedation scores, and extended time before requesting postoperative analgesia compared to Group C. These results suggest improved anesthetic quality and pain control with dexmedetomidine.

Conclusion: Intravenous dexmedetomidine enhances spinal anesthesia by prolonging block durations and improving sedation, potentially decreasing the need for postoperative opioids. This supports its use as an effective adjunct in anesthesia, contributing to safer, more effective pain management strategies.

Downloads

Download data is not yet available.

References

Al Mustafa MM, Abu Halaweh SA, Aloweidi AS, Murshidi MM, Ammari BA, Awwad ZM. Effect of dexmedetomidine added to spinal bupivacaine for urological procedures. Saudi Med J. 2009;30(3):365-70. PMID 19271064.

Bajwa SJ, Bajwa SK, Kaur J, Singh G, Arora V, Gupta S. Dexmedetomidine and clonidine in epidural anaesthesia: a comparative evaluation. Indian J Anaesth. 2011;55(2):116-21. doi: 10.4103/0019-5049.79883, PMID 21712865.

Gupta R, Verma R, Bogra J, Kohli M, Raman R, Kushwaha JK. A comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to bupivacaine. J Anaesthesiol Clin Pharmacol. 2011;27(3):339-43. doi: 10.4103/0970-9185.83678, PMID 21897504.

Kim JH, Hong JY, Choi DH. Effects of dexmedetomidine on intraoperative hemodynamics and propofol requirement in patients undergoing laparoscopic surgery. Korean J Anesthesiol. 2013;65(6):55-61. doi: 10.4097/kjae.2013.65.6S.

Sriganesh K, Saini J. Exacerbation of involuntary movements after propofol anesthesia in a patient with huntington disease. J Neurosurg Anesthesiol. 2013;25(2):212-4. doi: 10.1097/ANA.0b013e318288af99.

Memis D, Turan A, Karamanlioglu B, Pamukcu Z, Kurt I. Adding dexmedetomidine to lidocaine for intravenous regional anesthesia. Anesth Analg. 2004;98(3):835-40. doi: 10.1213/01.ane.0000100680.77978.66, PMID 14980948.

Naaz S, Ozair E. Dexmedetomidine in current anaesthesia practice a review. J Clin Diagn Res. 2014;8(10):GE01-4. doi: 10.7860/JCDR/2014/9624.4946, PMID 25478365.

Patel CR, Engineer SR, Shah BJ, Madhu S. The effect of dexmedetomidine continuous infusion as an adjuvant to general anesthesia on sevoflurane requirements: a study based on entropy analysis. J Anaesthesiol Clin Pharmacol. 2013;29(3):318-22. doi: 10.4103/0970-9185.117066, PMID 24106354.

Rahman K, Ambesh SP. Dexmedetomidine: an adjuvant making large inroads into clinical practice. Ann Card Anaesth_76_17. 2017;20(4):462-7. doi: 10.4103/aca.

Ozdemir BA, Sinha S, Karthikesalingam A, Poloniecki JD, Pearse RM, Grocott MP. Mortality of emergency general surgical patients and associations with hospital structures and processes. Br J Anaesth. 2016;116(1):54-62. doi: 10.1093/bja/aev372, PMID 26675949.

Moss JR, Watcha MF, Bendel LP, Mc Carthy DL, Witham SL, Glover CD. A multicenter randomized double-blind placebo controlled single-dose trial of the safety and efficacy of intravenous ibuprofen for treatment of pain in pediatric patients undergoing tonsillectomy. Paediatr Anaesth. 2014;24(5):483-9. doi: 10.1111/pan.12381, PMID 24646068.

Tufanogullari B, White PF, Peixoto MP, Kianpour D, Lacour T, Griffin J. Dexmedetomidine infusion during laparoscopic bariatric surgery: the effect on recovery outcome variables. Anesth Analg. 2008;106(6):1741-8. doi: 10.1213/ane.0b013e318172c47c, PMID 18499604.

Venn RM, Hell J, Grounds RM. Respiratory effects of dexmedeto3midine in the surgical patient requiring intensive care. Crit Care. 2000;4(5):302-8. doi: 10.1186/cc712, PMID 11056756.

Lee KH, Nam SH, Yoo SY, Jung CW, Bae SS, Lee JR. Vecuronium requirement during liver transplantation under sevoflurane anesthesia. J Anesth. 2010;24(5):683-6. doi: 10.1007/s00540-010-0982-6, PMID 20607311.

Esmaoglu A, Mizrak A, Akin A, Turk Y, Boyaci A. Addition of dexmedetomidine to lidocaine for intravenous regional anaesthesia. Eur J Anaesthesiol. 2005;22(6):447-51. doi: 10.1017/s0265021505000761, PMID 15991508.