Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R, Bulbul M, Baraka AS. Kaya FN, Yavascaoglu B, Turker G, Yildirim A, Gurbet A, Mogol EB, Ozcan B. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia.
Combined Spinal Epidural Anesthesia (CSEA) was performed at L3-4 and L2-3 separately and was technically uneventful. more A 71-year-old woman was scheduled for total knee replacement on left side.
Combined Spinal Epidural Anesthesia (CSEA) was performed at L3-4 and L2-3 separately and was technically uneventful.
Previous clinical studies showed that intravenous dexmedetomidine administration prolonged the sensory and motor blocks of bupivacaine spinal analgesia.
But clinical studies about the use of intrathecal DXM with local anesthesia in humans are scarce in the literature. found that 3μg DXM added to 12 mg spinal bupivacaine produced the significant short onset of sensory and motor block as well as significantly longer duration of sensory and motor block than bupivacaine. reported that intrathecal dexmedetomidine as an adjuvant to 12.5mg bupivacaine in spinal anesthesia has a dose dependant effect on the onset and regression of sensory and motor block.
After spinal block, the level of sensory block, defined as the dermatomal segment with loss of pain sensation to pin-prick with a 22 G hypodermic needle and cold sensation to alcohol swab was measured every 2 min after intrathecal injection.
The investigators recorded the peak sensory block level, time to peak block level from intrathecal injection, blood pressure and heart rate, and analgesic supplementation during operation. Effects of intrathecal dexmedetomidine on low-dose bupivacaine spinal anesthesia in elderly patients undergoing transurethral prostatectomy. A 22 years old, 158 cm of height, 40 kg weight, female, was under Spinal Anesthesia for tibia reconstruction on the right leg. The patient had a right tibia fracture, scheduled for tibia fixation.A 71-year-old woman was scheduled for total knee replacement on left side.In our previous study, low-dose diluted bupivacaine 5 mg provided sufficient anesthetic level when opioid was added with local anesthetic.However, opioid-induced side effects, such as pruritus, nausea, or vomiting, could be an obstacle in common use.Past medical history was hypertension, type 2 diabetes, bilateral degenerative knee pain.Spinal Anesthesia (SA) with 10 mg bupivacaine 0.5% heavy 20mcg fentanyl was effective for surgery.Epidural Anesthesia (EA) with levobupivacaine 0.1% fentanyl (2mcg/ml) was effective at 5 ml/h for postoperative analgesia.Eight hours post-op, she complained of having lost all feeling on the non-operative leg.On examination, she had diminished both touch sensory and motor power on the non-operative leg, but intact on the operative side with VAS at 2/10.Epidural catheter was receded 2 cm and the dose was lowered and paused.