title: Intrathecal dexmedetomidine as adjuvant for spinal anaesthesia for perianal ambulatory surgeries: A randomised double-blind controlled study.
abstract: OBJECTIVE
  The newer trend in regional anaesthesia for ambulatory anorectal surgeries advocate use of lower dose of local anaesthetic, providing segmental block with adjuvants such as opioids and α2 agonists to prolong analgesia. The current study investigated effects of addition of 5 μg of dexmedetomidine to 6 mg of hyperbaric bupivacaine on duration of analgesia, sensory and motor block characteristics for perianal ambulatory surgeries.
  
  
  METHODS
  This study is a prospective randomised controlled double blind study. Forty adult patients between 18 and 55 years of age were divided into 2 groups. Group D received intrathecal 0.5% hyperbaric bupivacaine 6 mg (1.2 ml) with injection dexmedetomidine 5 μg in 0.5 ml of normal saline and Group N received intrathecal 0.5% hyperbaric bupivacaine 6 mg (1.2 ml) with 0.5 ml of normal saline. The parameters assessed were time to regression of sensory blockade, motor blockade, ambulation, time to void, first administration of analgesic. Statistical analysis was done using appropriate tests.
  
  
  RESULTS
  Time for regression of sensory level and time for first administration of analgesic were prolonged in Group D (430.05 ± 89.13 min, 459.8 ± 100.9 min, respectively) in comparison to Group N (301.10 ± 94.86 min, 321.85 ± 95.08 min, respectively). However, the duration of motor blockade, time to ambulation, and time to void were also significantly prolonged in Group D (323.05 ± 54.58 min, 329.55 ± 54.06 min, 422.30 ± 87.59 min) than in Group N (220.10 ± 63.61 min, 221.60 ± 63.84 min, 328.45 ± 113.38 min).
  
  
  CONCLUSIONS
  Intrathecal dexmedetomidine 5 μg added to intrathecal bupivacaine 6 mg as adjuvant may not be suitable for ambulatory perianal surgeries due to prolongation of motor blockade.
authors.affiliation: Department of Anaesthesiology, Bangalore Medical College and Research Institute, Victoria Hospital, Bengaluru, Karnataka, India.
authors.forename: S S
authors.initials: SS
authors.lastname: Nethra
authors.affiliation: Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
authors.forename: M
authors.initials: M
authors.lastname: Sathesha
authors.affiliation: Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
authors.forename: Aanchal
authors.initials: A
authors.lastname: Dixit
authors.affiliation: Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
authors.forename: Pradeep A
authors.initials: PA
authors.lastname: Dongare
authors.affiliation: Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
authors.forename: S S
authors.initials: SS
authors.lastname: Harsoor
authors.affiliation: Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
authors.forename: D
authors.initials: D
authors.lastname: Devikarani
keywords: Adjuvant; ambulatory; dexmedetomidine; intrathecal
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