Spinal Anaesthesia with Levobupivacaine per se versus Combination of Levobupivacaine plus Dexmeditomidine: A Comparative Clinical Assessment

Abstract

Background:Spinal anaesthesia is a widely used technique for effective and uniformly distributed sensory and motor block with faster onset. Due to decreased cardiovascular and central nervous system toxicity, levobupivacaine is a good alternative for spinal anesthesia. Dexmedetomidine when used intrathecally is associated with prolonged motor and sensory block, hemodynamic stability, and less requirement of rescue analgesia in 24 h. Objective:This study was aimed to evaluate the clinical efficacy of levobupivacaine per se versus combination of levobupivacaine plus dexmedetomidine in spinal anaesthesia. Methods:One hundred and twenty patients between ages 18 and 75, in ASA I-II groups were included in the study with informed consent for elective surgeries under spinal anaesthesia. Subjects were randomly assigned to 2 groups. Group I: Isobaric levobupivacaine (3 ml, 15 mg, 0.5%) + 0.3 ml normal saline; Group II: Isobaric levobupivacaine (3 ml, 15 mg, 0.5%) plus dexmedetomidine (0.3 ml, 3 μg).Clinical efficacy was evaluated by assessing the arterial pressure, respiratory rate, heart rate, sensory and motor block levels, level of sedation, pain level and safety complications were monitored.Results:In the combination group mean onset of anaesthesia was significantly less and duration of sensory block was longer. Similarly, onset of motor block was quicker and duration was longer in the combination group. Addition of dexmedetomidine to levobupivacaine resulted into better analgesia profile and reduction in the need of analgesic of the post-operative pain management. Conclusion:It is concluded that addition of dexmedetomidine to levobupivacaine prolonged the postoperative analgesia and induce stable sensory and motor block which makes it preferable anaesthetic combination for major surgeries.