Original Research

Perioperative effect of epidural dexmedetomidine with intrathecal bupivacaine on haemodynamic parameters and quality of analgesia

Divya Jain, R M Khan, Devesh Kumar, Nishant Kumar
Southern African Journal of Anaesthesia and Analgesia | Vol 18, No 2 | a561 | DOI: https://doi.org/10.1080/22201173.2012.10872835 | © 2012 Divya Jain, R M Khan, Devesh Kumar, Nishant Kumar | This work is licensed under CC Attribution 4.0
Submitted: 03 November 2025 | Published: 01 March 2012

About the author(s)

Divya Jain,, India
R M Khan,, Oman
Devesh Kumar,, India
Nishant Kumar,, India

Full Text:

PDF (152KB)

Abstract

Background: The present study was a randomised controlled trial designed to evaluate the perioperative effect of epidural dexmedetomidine, in conjunction with intrathecal bupivacaine. Method: In this trial, 60 male patients of American Society of Anesthesiologists’ grades I and II, between 20-50 years of age, and posted for elective lower limb orthopaedic surgery, were selected. After written informed consent was obtained and a thorough preanaesthetic check-up carried out, the patients were randomly divided into two groups using the manual envelope randomisation technique. Group I received 2.5 ml of 0.5% bupivacaine intrathecally, plus 10 ml normal saline (NS) epidurally (control). Group II received 2.5 ml of 0.5% bupivacaine intrathecally, plus 2.0 μg/kg dexmedetomidine epidurally, made up to 10 ml with NS (study). Results: We observed a significant prolongation in the duration of analgesia to 424.1 minutes (Group II) in patients receiving epidural dexmedetomidine, in comparison to 140.0 minutes in patients receiving saline (Group I). There was a significant fall in the pulse rate and mean arterial pressure five minutes following epidural dexmedetomidine in Group II patients, which lasted throughout the study period. The majority of the patients in Group II were sedated, yet arousable, by verbal commands or light tactile stimulus (sedation scale 3-4) 10 ± 5 minutes following administration of dexmedetomidine in the epidural space. This decrease in the level of consciousness lasted for 45 ± 5 minutes. Conclusion: The addition of 2 μg/kg dexmedetomidine epidurally to 2.5 ml of intrathecal bupivacaine prolongs the duration of analgesia, and decreases the requirement of rescue analgesics in patients undergoing lower-limb orthopaedic surgery, with a significant fall in pulse rate and mean arterial pressure.

Keywords

Epidural dexmedetomidine with intrathecal bupivacaine; Postoperative analgesia; Intraoperative hemodynamics; Lower limb orthopaedic surgeries

Metrics

Total abstract views: 215
Total article views: 51

 

Crossref Citations

1. Epidural Kateter Uygulanan Total Abdominal Histerektomi Operasyonu Geçiren Hastalarda Deksmedetomidinin Postoperatif Analjezik Kullanımına Etkileri
Ali KOÇMAN, Ümit FİĞANÇİÇEK, Filiz ALKAYA SOLMAZ, Pakize KIRDEMİR
SDÜ Tıp Fakültesi Dergisi  vol: 26  issue: 2  first page: 165  year: 2019  
doi: 10.17343/sdutfd.383697

2. Comparative evaluation of dexmedetomidine and ketamine for epidural analgesia in lower limb orthopedic surgeries
Ayush Shah, Malti J Pandya
Indian Journal of Clinical Anaesthesia  vol: 7  issue: 1  first page: 166  year: 2020  
doi: 10.18231/j.ijca.2020.029

3. Comparison of two different doses of dexmedetomidine for continuous epidural analgesia for lower limb surgeries: A randomized double-blind study
Pranjali Kurhekar, Sam Blessy Sheba, Sathyasuba Meenakshisundaram, Raghuraman M. Sethuraman, Neeta Parlikar
Journal of Anaesthesiology Clinical Pharmacology  vol: 40  issue: 3  first page: 451  year: 2024  
doi: 10.4103/joacp.joacp_88_23

4. ANALGESIC EFFICACY AND SEDATIVE EFFECT OF DEXMEDETOMIDINE VERSUS CLONIDINE AS AN ADJUVANT TO EPIDURAL ROPIVACAINE IN LOWER LIMB SURGERY: A COMPARATIVE STUDY
Amalendu Bikas Chatterjee, Suman Chatterjee, Somnath Dey
Journal of Evidence Based Medicine and Healthcare  vol: 6  issue: 5  first page: 280  year: 2019  
doi: 10.18410/jebmh/2019/58

5. Ultrasound-guided infraclavicular brachial plexus block using bupivacaine alone or combined with dexmedetomidine for hand and forearm surgeries
Yahya H. Morsi, Ramadan A.E. Ammar, Ahmed M.A. Elshafie
Research and Opinion in Anesthesia & Intensive Care  vol: 9  issue: 1  first page: 52  year: 2022  
doi: 10.4103/roaic.roaic_24_21

6. Dexmedetomidine as a neuraxial adjuvant for prevention of perioperative shivering: Meta-analysis of randomized controlled trials
Jian Zhang, Xuena Zhang, Hui Wang, Haibin Zhou, Tian Tian, Anshi Wu, JianJun Yang
PLOS ONE  vol: 12  issue: 8  first page: e0183154  year: 2017  
doi: 10.1371/journal.pone.0183154

7.

Comparative Study of Fentanyl vs Dexmedetomidine as Adjuvants to Intrathecal Bupivacaine in Cesarean Section: A Randomized, Double-Blind Clinical Trial


Fatemeh Khosravi, Mehdi Sharifi, Hashem Jarineshin
Journal of Pain Research  vol: Volume 13  first page: 2475  year: 2020  
doi: 10.2147/JPR.S265161

8. Evaluation of low-dose dexmedetomidine and neostigmine with bupivacaine for postoperative analgesia in orthopedic surgeries: A prospective randomized double-blind study
Ashima Sharma, NareshJ Kumar, Mohammad Azharuddin, LalithC Mohan, Gopinath Ramachandran
Journal of Anaesthesiology Clinical Pharmacology  vol: 32  issue: 2  first page: 187  year: 2016  
doi: 10.4103/0970-9185.173355

9. Comparison of the analgesic efficacy of a single dose of epidural dexmedetomidine versus fentanyl as an adjuvant to bupivacaine in abdominal surgery
DurgaPrasad Sekhar, Lakshmi Kumar, Rajesh Kesavan, Shyamsundar Purushottaman, ZubairUmer Mohammed, Sunil Rajan
Anesthesia: Essays and Researches  vol: 13  issue: 3  first page: 465  year: 2019  
doi: 10.4103/aer.AER_102_19

10. Effect of mini-dose epidural dexmedetomidine in elective cesarean section using combined spinal–epidural anesthesia: a randomized double-blinded controlled study
Ayman Abdelmaksoud Yousef, Hesham Abdalaziz Salem, Mostafa Zein Moustafa
Journal of Anesthesia  vol: 29  issue: 5  first page: 708  year: 2015  
doi: 10.1007/s00540-015-2027-7

11. USE OF DEXMEDETOMIDINE AS ADJUVANT IN OBLIQUE SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK
Swati Bisht, Sunitha Kuruvadi Sreeramalu, Gopal Sadanand
Journal of Evolution of Medical and Dental Sciences  vol: 5  issue: 02  first page: 106  year: 2016  
doi: 10.14260/jemds/2016/25

12. Efficacy of dexmedetomidine on postoperative shivering: a meta-analysis of clinical trials
Zhen-Xiu Liu, Feng-Ying Xu, Xiao Liang, Miao Zhou, Liang Wu, Jing-Ru Wu, Jian-Hua Xia, Zui Zou
Canadian Journal of Anesthesia/Journal canadien d'anesthésie  vol: 62  issue: 7  first page: 816  year: 2015  
doi: 10.1007/s12630-015-0368-1

13. Addition of dexmedetomidine to bupivacaine in transversus abdominis plane block potentiates post-operative pain relief among abdominal hysterectomy patients: A prospective randomized controlled trial
Waleed A. Almarakbi, Abdullah M. Kaki
Saudi Journal of Anaesthesia  vol: 8  issue: 2  first page: 161  year: 2014  
doi: 10.4103/1658-354X.130683

14. Effect of Epidural Dexmedetomidine Combined With Ropivacaine in Labor Analgesia
Yang Zhao, Yan Xin, Yongbo Liu, Xuanlong Yi, Yingzhi Liu
The Clinical Journal of Pain  vol: 33  issue: 4  first page: 319  year: 2017  
doi: 10.1097/AJP.0000000000000411