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Spinal anaesthesia is commonly used for abdominal and lower limb surgeries. Dexmedetomidine, a new highly selective α2 agonist drug, is now being evaluated as a potential neuraxial adjuvant. This study has been designed to evaluate the addition of two doses of dexmedetomidine (10μg and 15μg) to 0.5% hyperbaric bupivacaine 3ml intrathecally for elective abdominal and lower limb surgeries. In a simple randomized study, 90 patients aged between 18-60 years of ASA I and II were randomized into three groups i.e., group I, II and III (n=30). All patients received a drug volume of 3.5 ml containing 3 ml hyperbaric bupivacaine (15 mg). They received dexmedetomidine 10μg (Group II) or 15μg (Group III) diluted to 0.5ml with 0.9% saline added to bupivacaine in the same syringe; the control group (Group I) received 0.5ml of 0.9% saline added to bupivacaine. It was found that the onset of sensory block upto T10 and motor block is statistically significantly faster in group II (155.17 sec and 203.83 sec) and III (99.37 sec and 170.13 sec) over group I (263.16 sec and 337.50 sec) in a dose dependent manner. The mean time for two segment regression, the mean time to sensory regression to S1, the mean duration of analgesia and the mean duration of motor blockade is significantly prolonged in Group III (141.67 min, 447.83 min, 400.67 min, 475.17 min) over Group II (106.17 min, 332.83 min, 287.67 min, 346.50 min) and Group II over Group I (97.33 min, 276.67 min, 243.17 min, 276.83 min) in a dose dependent manner (p<0.001). The data reveal that 15 μg of dexmedetomidine added to local anaesthetic in subarachnoid block to be a better adjuvant in prolonging the sensory and motor blockade intraoperatively and the duration of postoperative analgesia compared to 10 μg, without significant adverse effects. It is an attractive option for prolonged surgeries of the lower limb precluding the need for use of general anaesthetics and epidural anaesthesia.

The Effect of Dexmedetomidine Dosage on Duration of Spinal Anaesthesia using Hyperbaric Bupivacaine for Abdominal and Lower Extremity Surgeries