Anesthetic and analgesic efficacy, hemodynamic changes, andsedation following addition of dexmedetomidine to lignocainein intravenous regional anesthesia for minor hand surgery

Background and aims Adding dexmedetomidine to local anesthetics in intravenous regional anesthesia has been found to produce effective anesthesia and analgesia for minor hand surgery. The aim of this study was to compare hemodynamic changes, adverse effects, patient satisfaction, and anesthetic, analgesic, and sedation qualities in patients who received lidocaine only versus those who received dexmedetomidine with lidocaine during minor hand surgery. MethodsOne hundred patients scheduled for minor hand surgery were randomly allocated intotwo equal groups: group L and group DL. Patients in group L received 3 mg/kg lidocaine 0.5% (maximum dose 200 mg), and patients in group DL received 3 mg/kg lidocaine 0.5% (maximum dose 200 mg) + 0.5 μg/kg dexmedetomidine; the total volume was diluted to 40 ml with normal saline 0.9% in both groups and injected at a rate of 20 ml/min. Anesthesia, analgesia, and sedation qualities, hemodynamic changes, patient satisfaction, and adverse effects were recorded.ResultsThe studied groups showed no significant difference in demographic data. In hemodynamics, mean arterial blood pressure and heart rate showed a statistically significant difference during and up to 30 min after tourniquet release (P 0.001), and oxygen saturation showed no statistically significant difference during and after surgery (P 0.05). There were statistically significant differences between the two groups (P 0.05) as regards the quality of anesthesia, time of regression of sensory and motor blocks, and patient satisfaction. There were more patients who reported excellent satisfaction in the DL group (76%) compared with the L group (20%). Intraoperative and postoperative analgesic requirements were greater in the lidocaine group than in the dexmedetomidine group, and postoperative pain score (visual analog scale) was lower in the DL group compared with L group. Sedation score after release of tourniquet was significantly higher in the DL group compared with the L group except in the first 5 min. Conclusion On the basis of the results in this study we concluded that dexmedetomidine is a good adjuvantanesthetic, analgesic, and sedative agent in intravenous regional anesthesia.