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Comparative evaluation of bupivacaine alone versus bupivacaine and dexmedetomidine for spinal anesthesia in infraumbilical surgeries

Introduction The efficacy of local anesthetics in spinal anesthesia can be enhanced by using adjuvants like opioids and α2 -agonists. Aim The present study was designed to determine the analgesic efficacy and side effects of adding dexmedetomidine to bupivacaine in spinal anesthesia for infraumbilical surgeries. Patients and methods In a prospective, randomized, double-blind study, 100 patients were randomly divided into two groups of 50 each, after taking their informed consent. Spinal anesthesia was achieved with 12.5 mg of 0.5% hyperbaric bupivacaine in group B (n = 50) and with 12.5 mg of 0.5% hyperbaric bupivacaine plus 10 μg of dexmedetomidine in group D (n = 50). The two groups were compared with respect to hemodynamic parameters, onset of sensory block to T10 and regression to S1, time to achieve Bromage 3 and regression to Bromage 0, duration of analgesia, number of doses of rescue analgesia required, and complications occurring in 24 h. Results Significant difference was observed in relation to onset of sensory block [12.7 ± 1.015 min in group B and 6.84 ± 0.792 min in group D (P < 0.001)], total duration of sensory block [177.74 ± 28.573 min in group B and 353.36 ± 12.138 min in group D (P < 0.001)], total duration of motor block [146.94 ± 9.173 min in group B and 318.36 ± 9.374 min in group D (P < 0.001)], duration of analgesia [283.96 ± 11.165 min in group D and 126.34 ± 7.684 min in group B (P < 0.001)], and total number of doses of rescue analgesia required in 24 h [1.44 ± 0.501 in group D and 2.56 ± 0.675 in group B (P < 0.001)]. Conclusion Addition of dexmedetomidine to bupivacaine leads to early onset of sensory and motor block with prolonged duration, and patients remained pain free for a longer period with decreased demand for rescue analgesia in the postoperative period as compared with plain bupivacaine.