Comparison of 5µg and 10 µg of Dexmedetomidine as an adjuvant with Bupivacaine (heavy) under Spinal anaesthesia in Urological surgeries

Objectives: This study is to know the efficacy of 5µg and 10µg of Dexmedetomidine adding to 0.5% bupivacaine (heavy) under spinal anaesthesia for urological procedures. The purpose of our study is to know sensory onset, motor onset, sensory blockade duration, motor blockade duration, effective analgesia duration, rescue analgesia duration, VAS score, haemodynamic factors like heart rate and blood pressure and also untowards adverse effects. Materials and Method: In a prospective randomized study, 120 patients of ASA grade I/II aged between 20 - 60 years undergoing urological surgeries were divided randomly into three groups of 40 each. Group D5- 0.5% hyperbaric bupivacaine 12.5 mg (2.5ml) + 5 µg Dexmedetomidine, Group D10- 0.5% hyperbaric bupivacaine 12.5 mg (2.5ml) + 10 µg Dexmedetomidine, Group BS- 0.5% hyperbaric bupivacaine 12.5mg + normal saline 0.5ml. Results was analysed using one way ANOVA and Kruskal wallis test. p<0.05 considered statistically significant. Results: In Dexmedetomidine groups sensory and motor blockade onset was early (Group D10>Group D5). Sensory blockade duration and motor blockade duration was increased. Effective and rescue analgesia duration was also increased in the order of GroupD10>Group D5>Group BS. There was no clinically significant haemodynamic parameters alteration without any adverse effects/complication among three groups. Conclusion: 10µg dexmedetomidine enhances the duration of analgesia and patients remained pain free for a longer period of duration in post-operative period compared to plain bupivacaine or 5µg dexmedetomidine with better haemodynamic stability with minimal or no adverse effects.