The Effect of Adding Dexmedetomidine to Epidural Anesthesia for Lower Urinary Tract Surgeries, MANAR M. EL-KHOLY, ASHGAN R. ALY, NAZMY E. SEIF, AHMED R. ABD EL-HAKIM and AHMED SH. IBRAHIM
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The Effect of Adding Dexmedetomidine to Epidural Anesthesia for Lower Urinary Tract Surgeries, MANAR M. EL-KHOLY, ASHGAN R. ALY, NAZMY E. SEIF, AHMED R. ABD EL-HAKIM and AHMED SH. IBRAHIM
Abstract
Background: Epidural anesthesia is a safe and inexpensive technique with the advantage of providing surgical anesthesia and prolonged postoperative pain relief. It is also an effective treatment of operative pain as it blunts autonomic, somatic and endocrine responses. This study showed the effect of adding dexmedetomidine to epidural bupivacaine in anesthesia for lower urinary tract surgeries, with respect to onset of action, potency, duration of the block and the total dose of bupivacaine consumption during surgery as well hemodynamic changes.
Methods: 40 patients, ASA I/II were enrolled into the study. All patients had epidural anesthesia and randomly allocated into one of two groups. Group C: (20 patients) the patient received 10ml of bupivacaine 0.5% and Group D: (20 patients): The patient received 10ml of bupivacaine 0.5% plus dexmedetomidine in a dose of 1mg/kg diluted in 1ml normal saline. In both groups assessment was done after 10 minutes aiming to achieve T10 sensory level and G3 motor block. Otherwise incremental doses of 5ml bupivacaine 0.5% were given without additives.
Results: This study demonstrated that a more prolonged duration of action was recorded in the dexmedetomidine group. In addition, total dose consumption of the local anes-thetic was lower than that of the control group. Hemodynamic variables were stable and there were no significant differences between groups.
Conclusion: Dexmedetomidine is effective as a useful adjuvant to local anesthetic for epidural anesthesia. It has a more prolonged duration of action and an increased potency of the block. The studied drug effectively decreased the total dose requirements of local anesthetic drugs. No significant side effects were observed throughout the study period.