Key result
Subarachnoid dexmedetomidine speeds block onset and reduces 24-hour morphine use versus magnesium sulfate and saline.
Why the study?
Addition of adjuvants to local anesthetics improves the quality of subarachnoid block, but the comparative effects of dexmedetomidine versus magnesium sulfate as intrathecal adjuvants were unclear in classical repair surgery.
Does the addition of dexmedetomidine or magnesium sulfate to intrathecal bupivacaine improve the quality of spinal anesthesia in adult female patients undergoing classical repair surgery?
RCT (n=75)
double-blinded
randomized
Does the addition of dexmedetomidine or magnesium sulfate to intrathecal bupivacaine improve the quality of spinal anesthesia in adult female patients undergoing classical repair surgery?
Intrathecal dexmedetomidine is superior to magnesium sulfate as an adjuvant to bupivacaine for spinal anesthesia, providing faster block onset and improved postoperative analgesia.
Supports dexmedetomidine as preferred intrathecal adjuvant to bupivacaine; extends RCT evidence for faster block onset and reduced opioid needs.
Background Spinal anesthesia has several benefits over general anesthesia. Addition of adjuvants to local anesthetics improves the quality of the subarachnoid block.Objective We attempted to improve the quality of spinal anesthesia by the addition of magnesium sulfate or dexmedetomidine to intrathecal bupivacaine in patients undergoing classical repair surgery as regards primary outcome (quality of spinal anesthesia) and secondary outcomes (effect on hemodynamics and incidence of complications).Patients and methods This prospective randomized double-blinded controlled clinical study was carried out on 75 adult female patients scheduled for classical repair surgeries under spinal anesthesia who were assigned into three equal groups. Group D: 15 mg of 0.5% hyperbaric bupivacaine plus 10 μg dexmedetomidine was given to the patients. Group M: patients received 15 mg of 0.5% hyperbaric bupivacaine plus 0.5 ml magnesium sulfate (50 mg). Group C: patients received 15 mg of 0.5% hyperbaric bupivacaine plus 0.5 ml normal saline as control. The comparison was made among the three groups in regards to onset time of sensory and motor block, degree of postoperative pain relief, effect on hemodynamic stability, and total postoperative morphine consumption, and complications were recorded.Results There was a statistical difference among the three groups as regards the onset time of both sensory and motor block, which was faster in group D than in group C, and both were faster than group M. The duration of postoperative analgesia was significantly prolonged in D and M groups compared with the control group. The requirements of morphine sulfate in the first 24 h were significantly lower in the D and M groups compared with the control group.Conclusion Subarachnoid dexmedetomidine supplementation of spinal block was found to be a better option than intrathecal magnesium sulfate in patients undergoing classical repair surgeries, as it provides rapid onset of sensory and motor block; also, it improves the quality of postoperative analgesia and reduces postoperative analgesic requirements.
No takes yet. Share an insight, caveat, or question.
Seyam et al. (2020) conducted an RCT in classical repair surgery (n=75). Dexmedetomidine or Magnesium sulfate vs. Normal saline was evaluated on Quality of spinal anesthesia (onset time of sensory and motor block). Subarachnoid dexmedetomidine supplementation provided faster onset of sensory and motor block and reduced 24-hour morphine requirements compared to magnesium sulfate and saline control.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: