Double Blinded Randomized Controlled Trial To Compare Post-Operative Analgesic Effect Of Dexmedetomidine And Morphine As Adjuvant To Intrathecal Bupivacaine In Infra-umbilical Surgeries
Description
adjuvant for subarachnoid block-comparison bertwen two drugs-Morphine and Dexmedetomidine
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• Informed consent, written in their own language was obtained from all the patients. • Patients were allocated to two groups by computer generated random assignment prior to the start of the study. Both the patients and operators (anesthetists, intraoperative and postoperative observers and recorders) were unaware of the group allocation. • A third person not involved in the study prepared the medication solution. Group M, the control group, received 15mg of 0.5% hyperbaric bupivacaine with 200 µg of preservative free morphine. Group D which is the test group received 15 mg of 0.5% hyperbaric bupivacaine with 5 µg of dexmedetomidine. The volume of drug administered was made to 3.1ml in both the groups. Electrocardiography, pulse -oximetry (SpO2 ) and non-invasive blood pressure (NIBP) were connected to the patient and baseline values were documented. • Under all aseptic precautions, subarachnoid block was administered in sitting position with 25 gauge Quincke needle at L3 -L4 /L4 -L5 space by midline approach. All the groups received 15mg of 0.5% hyperbaric bupivacaine with respective adjuvants in 5 ml syringes. • Immediately after giving injection patients were made to lie down in supine position. The completion of injection was taken as time zero of induction of anaesthesia. • An anesthesiologist who was not aware of group allocation, also blinded to the study drug recorded the observations. • Sensory level was monitored every minute for initial 10 minutes, every 5 minutes for next 20 minutes and every 30 minutes thereafter till the end of the surgery using spirit soaked gauze. Time for onset of sensory blockade, which is the time to achieve sensory level of T10, was noted. The highest sensory level achieved was also documented. • Motor blockade was assessed using Bromage scale: • Grade 0 – No weakness, full power, • Grade 1 – will be able to flex knees but won’t be able raise legs, • Grade 2 – Only foot movements, • Grade 3 – Complete paralysis. • Time taken to achieve Bromage grade 3 was noted as the time for onset of motor block.Patients did not receive any premedication. All the patients were preloaded with 10 mL/kg of Ringer lactate solution through 18 gauge intravenous (IV) cannula half an hour prior to the procedure Electrocardiography, pulse -oximetry (SpO2 ) and non-invasive blood pressure (NIBP) were connected to the patient and baseline values were documented.