Comparison of Intrathecal Dexmedetomedine with Dexamethasone as Adjuvant to Bupivacaine in Caesarian Section: A Double Blind Study
DOI:
https://doi.org/10.51273/esc23.251319413Keywords:
Dexmedetomedine, Dexamethasone,, Caesarian Section, Spinal AnaesthesiaAbstract
Objective: To compare the effects of dexmedetomidine versus dexamethasone as intrathecal additives in elective LSCS.
Material and Method: Sixty parturients at term aged 18-40 years, were included in this study. Spinal anaesthesia was administered to all for caesarian section. 0.5% hyperbaric bupivacaine (10mg) was given to all patients. D group (n=30) was given dexamethasone 6mg as adjuvant. Dexmedetomedine (0.5 ml) 5μg was added in Group BD. Similar syringes were used for drugs to ensure blinding. Haemodynamic changes were measured. Pinprick method was used to assess the onset and duration of sensory block. Time to two segment sensory regression was documented. Modified Bromage scale assessed the onset and duration of motor block.
Results: The mean sensory block onset time was earlier with dexamethasone than Dexmedetomedine. Duration of analgesia and two segment sensory regression time and duration of motor block was significantly longer with dexmedetomidine (Table:2 & 3). Significant decrease in systolic and diastolic blood pressure was seen from baseline till uterine incision in both groups (Fig:B & C). Incidence of postoperative shivering, nausea and vomiting were significantly reduced with dexmedetomidine (Fig: D & E).
Conclusion: Dexmedetomidine is superior to dexamethasone in providing better sensory and motor block along with prolonged analgesia duration.
References
Abdelhady BS, Allam TM, Dabour YS. Comparison Between Analgesic Effect of Dexamethasone and Dexmedetomidine as an Adjuvant to Bupivacaine for Spinal Anaesthesia for Elective Caesarean Sections. Journal of Anesthesia and Anesthetic Drugs 2022;2(1): 2200102.
Sushruth MR, Rao DG. Effect of adding intrathecal dexmedetomidine as an adjuvant to hyperbaric bupivacaine for elective cesarean section. Anaesth Pain & Intensive Care 2018;22(3):348-354.
Elgebaly AS. Evaluation the Effects of Intravenous vs. Spinal Dexmedetomidine during Anesthesia for Cesarean Sections with Severe Pre-Eclampsia. J Anesth Clin Res 2018; 9: 801.
Teymourian H, Khorasanizadeh S, Ansar P, Nazari L, Ebrahimy Dehkordy M. Comparison of the Effect of Bupivacaine in Combination with Dexmedetomidine with Bupivacaine Plus Placebo on Neonatal Apgar Score, Bispectral Index, and Sedation Level of Parturient Women, Anesth Pain Med. 2018;8(5):e81947.
Elshahawy ME, Taman HI, Elawady MS, Farid AM. Comparison of Dexmedetomidine Versus Dexamethasone as Adjuvants to Intrathecal Bupivacaine in Emergency Orthopedic Lower Limb Operations. EJHM 2022;88: 2382-2387.
Bi Y-h, Wu J-m, Zhang Y-z and Zhang R-q. Effect of Different Doses of Intrathecal Dexmedetomidine as an Adjuvant Combined With Hyperbaric Ropivacaine in Patients Undergoing Cesarean Section. Front Pharmacol 2020;11:1-9.
El-Hamed Hassan AA, Al-Kumity AA, Ahmed AMS, Shabaiek IAL. Clinical comparative study between intrathecal dexmedetomidine and dexamethasone on prolonging the duration of intrathecal blockade in lower limb orthopedic surgery. Al-Azhar Med J 2021;50(2):1467-1478.
Pocham V, Naik G. A Prospective Randomized Double-Blind Study Comparing Intrathecal Dexmedetomidine and Fentanyl as Adjuvants to Bupivacaine in Infra Umbilical Surgeries. Int J Sci Stud 2018;6(7):1-14.
Xia F, Chang X, Zhang Y, Wang L, and Xiao F. The effect of intrathecal dexmedetomidine on the dose requirement of hyperbaric bupivacaine in spinal anaesthesia for caesarean section: a prospective, double blinded, randomized study. BMC Anesthesiology 2018;18:74
Samal S, Pattnaik SK, Mohta A, Jena SK. Intrathecal dexmedetomidine versus morphine as adjuvant to bupivacaine in elective LSCS: a comparative study. IJCA 2016;3(4): 607-610.
Sharma A, Kumar R. Assessment of efficacy of Dexamethasone as an adjuvant to Bupivacaine for spinal anesthesia. J Adv Med Dent Scie Res 2019;7(8): 218-222.
Khosravi F, Sharifi M, Jarineshin H. Comparative Study of Fentanyl vs Dexmedetomidine as Adjuvants to Intrathecal Bupivacaine in Cesarean Section: A Randomized, Double-Blind Clinical Trial. Journal of Pain Research 2020;13: 2475–2482.
Noor El-Din T, Hussein M, Abd El-galil A, Abdellatif AE. Intrathecal Fentanyl versus Dexmedetomedine as Adjuvants to Bupivacaine for Cesarean Section. IJMA 2021; 3[1]: 1083-1087.
Shahid A, Shafqat H, Maqbool S, Ali A, Feroze R. Determining the Effect of Intrathecal Dexmedetomidine on Postoperative Pain Relief after Cesarean Section. J Bahria Uni Med Dental Coll. 2022; 12(4):181-5.
Ismaiel MAMAN, El Safty OMT, El-Agamy AS , Mohamed OMZ, Ali MMM. A comparative study between dexmedetomidine and dexamethasone as an intrathecal adjuvant for prevention of perioperative shivering in caesarian section. Ain-Shams Journal of Anesthesiology 2022;12:53.