Comparison of The Effect of Intrathecal Hyperbaric 10.5% Bupivacaine Alone And With Addition of Dexmedetomidine On First Anlgesic request In Post Operative Care Unit Following Elective Cesarean Section In Association To Body Mass Index And Duration of Analgesia

Abstract

For patients undergoing elective cesarean, spinal anesthesia has been considered a preferred method of anesthesia. Conventionally, Bupivacaine was used but now dexemetomidine, a newer drug as compared to Bupivacaine is being used. Due to short usage tenure of dexemetomidine as a spinal anesthesia, data regarding its afficacy is lacking in Pakistan.Objectives:  To compare the mean duration of spinal anasthesia between hyperbaric bupivacaine 0.5% alone versus hyperbaric bupivacaine 0.5% with dexmedetomidine on first analgesic request for women undergoing elective cesarean section alongwith examining the affect of BMI on Dexemedetomidine. Methods: Spinal anesthesia was administered in the sitting position under sterile conditions with 25G pencil point needle. Patient was positioned in a supine position tilting towards left after successful intra thecal injection. Group A cases received hyperbaric 0.5% BPV (2.25ml) with 5ug DXM (0.25ml) and those in Group B received only 0.5% BPV (2.25ml) with 0.25ml normal saline under full aseptic measures. These patients underwent cesarean section and were assessed in post-operative time after every 30 minutes to first request of analgesia which were given if there was pain of 4 or more on visual analogue scale. Results: In Group A, mean and SDs for duration of analgesia was 359.73+8.021 minutes. In Group B, mean and SDs for duration of analgesia was 182.30+7.720 minutes. Results depicted mean and SD for BMI of the patients to be 25.66+1.52. Conclusion: In this study, hyperbaric bupivacaine 0.5% with DXM in spinal anesthesia for patients undergoing caesarean section significantly prolonged the duration of analgesia in normal to slightly overweight individuals.