Conscious Sedation With Dexmedetomidine/ Midazolam Infusion In Patients With Intrathecal Bupivacaine For Infraumbilical Surgeries.

Indian Journal of Applied Basic Medical Sciences
Year: 2019, Volume: 21(A), Issue. (1), January
First page: (197) Last page: (220)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi:

Conscious Sedation With Dexmedetomidine/ Midazolam Infusion In Patients With Intrathecal Bupivacaine For Infraumbilical Surgeries.
Devanshi Shah1 and Manisha kapdi2*
1Resident in Anesthesia, 2Associate professor in Anaesthesia,V S General Hospital and NHL medical college Ahmedabad pin 380006
Corresponding author email id: manisha_kapdi@yahoo.com

Online Published on 02-Jan-2019

ABSTRACT

Background: spinal anesthesia is very much common regional anesthesia. Assurance and conscious sedation is required to make patients calm and co-operative. We have also assessed effect of dexmedetomidine/ midazolam infusion on sensorimotor characteristics of spinal bupivacaine.Material and methods :We selected 50patients for the study, 25 in each group.Group-D : Received a loading dose of I.V dexmedetomidine 0.5mcg/kg by infusion pump over 10 min + 0.5mcg/kg/hr infusion till the end of surgery.Group-M : Recieved a loading dose of I.V midazolam 0.02mg/kg by infusion pump over 10 min 0.04mg/kg/hr infusion till the end of surgery. Observation The pulse rate & SBP in group D was significantly lower as compared to group M from 10 minutes to 120 minutes after subarachnoid block. Significant difference was seen between group D and group M. There was no statistically significant change in pulse rate between 120mins to 24 hrs postoperatively between the groups.There was no statistically significant difference up to 24 hrs post operatively.There was no significant change in RR and SPO2 in any group.Highest sensory level and duration of sensory and motor blockade and duration of analgesia and No. Of analgesic requests in 24 hrs were compared.Intraoperative and postoperative adverse effects were noted.Higher sensory level (T5 28% and T6 72% ) is achieved in Group D as compared to Group M ( T6 44% and T8 56%).Time to regression by two dermatome (min) in group D is 211 ±11.4 where as in group M is 162±11.3 which is highly significant ( p < 0.001 ).Time of 1st rescue analgesic (min) in group D is 325 ± 23.7 where as in group M is 218 ± 15.3 which is highly significant ( p < 0.001 ).Time of motor block to Bromage 1 (min) in group D is 246 ± 16.5where as in group M is 236 ± 16.6 which is statistically significant ( p < 0.05).Analgesic requests in 24 hrs (no.) in group D is1.96 ± 0.35 where as in group M is 3.4 ± 0.50 which is highly significant ( p < 0.001 ).In group D hypotension occured in 2 (8%) patients and bradycardia in 5 (20%) patients. No other adverse effect noticed in group D. In group M respiratory depression occured in 4 (16%) patients and shivering in 2 (8%) patients. Conclusion: DEXMEDETOMIDIINE is more effective supplementation then Midazolam in terms of sedation as well as prolonged sensorimotor charestristics of inyrathecal bupivacaine.

Keywords

concious Sedation,dexmedetomidine infusion, midazolam infusion, intrathecal bupivacaine.

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