Effects of Two Different Doses of Intrathecal Dexmedetomidine on the Perioperative Clinical Profile of Bupivacaine-Induced Spinal Anesthesia for Cesarean Section

Introduction: Spinal anesthesia gained great popularity in cesarean delivery in the last decades. Different additives to bupivacaine were used to increase the duration of analgesia after spinal anesthesia specially opioids and α2 agonists e.g. dexmedetomidine. The best dose of intrathecal dexmedetomi-dine (DEX) with the least side effects was not determined before in the obstetric patient population.Methods: A randomized controlled trial was done in Obstetric Department in Cairo University Hospitals during the year 2015. Sixty patients were involved where they are divided into two groups, one group received intrathecal bupivacaine plus 5mg DEX (group BD5), and the other group received bupivacaine plus 15mg DEX (group BD 15). The time to two sensory block segment regression, the peak sensory level of the block, the time to S1 level sensory regression, the intraoperative and early postoperative hemodynamic variables, and side effects e.g. nausea and vomiting were determined.Results: The mean time to two segment dermatomal regression showed no statistically significant difference between the two groups (p-value 0.05). The mean time of sensory regression to S1 showed statistically significant prolongation in group BD 15 (383±40.6) min compared to group BD 5 (317.3±51.5) min (p=0.000). There was no significant difference between the two groups regarding hemo-dynamics, sedation and side effects.Conclusion: The addition of DEX in two different doses as an intrathecal adjuvant to isobaric bupivacaine 0.5% in elective Caesarean section increased the durations of sensory and motor block clinically in a dose dependant manner without significant increase in side effects.