Volume : 7, Issue : 5, May - 2018

Addition of intrathecal Dexamethasone to Bupivacaine for spinal anesthesia in orthopedic surgery

Dr Krishna Kumar Tripathi, Dr Prasoon Pathak, Dr Noopur Chakarvarty

Abstract :

<p>&nbsp;Objectives: Spinal anesthesia provides profound nerve block that can be produced in a large part of the</p> <div>body by simple injection of a small amount of local anesthetic. But Intrathecal local anesthetics have limited</div> <div>duration. Different drugs have been used as additive to prolong spinal anesthesia. corticosteroids in prolonging the analgesic effects of</div> <div>local anesthetics in peripheral nerves is well documented. The purpose of this investigation was to determine whether the addition of</div> <div>dexamethasone to intrathecal bupivacaine would prolong the duration of sensory analgesia or not.</div> <div>Methods: We conducted a randomized, prospective, double-blind, case-control, clinical trial. A total of 50 patients were scheduled for</div> <div>orthopedic surgery under spinal anesthesia. The patients were randomly allocated to receive 15 mg hyperbaric bupivacaine 0.5% with 2 cc</div> <div>normal saline (control group) or 15 mg hyperbaric bupivacaine 0.5% plus 8 mg dexamethasone (case group) intrathecally. The patients</div> <div>were evaluated for quality, quantity, and duration of block; blood pressure, heart rate, nausea, and vomiting or other complications.</div> <div>Results:</div> <div>There were no signi􀃶cation differences in sensory level, and onset time of the sensory block between two groups. Sensory block duration in</div> <div>the case group was 118&plusmn;10.68 minutes and in the control group was 88.44&plusmn;8.37 minutes which was signi􀃶cantly higher in the case group</div> <div>(P&lt;0.001). The duration of analgesia was 408.92&plusmn;72.44 minutes in the case group; whereas it was 223&plusmn;43.67 minutes in the control group</div> <div>(P&lt;0.001). The frequency of complications was not different between two groups.</div>