Dexmedetomidine in Subarachnoidal Anesthesia
Conditions
Brief summary
Dexmedetomidine, highly selective agonist for alpha-2 receptors, enhances the sensory and motor block with prolonged postoperative analgesia without hemodynamic compromise. OBJECTIVE: To evaluate effects of dexmedetomidine vs fentanyl with hyperbaric bupivacaine spinal anesthesia for lower abdominal surgeries. METHODS: double-blind, randomized, American Society Anesthesiologist classification (ASA) : I - II, 18-65 years. F group (23 patients) received 25 mcg fentanyl, Group D (27 patients), 10 mcg dexmedetomidine with 12.5 mg hyperbaric bupivacaine . 0,02mgrs morphine / kg intravenously if EVA≥4was administered in postoperative period. Hemodynamic variables and O2 saturation intraoperatively was recorded, EVA every 4 hours, side effects, sensory block, motor, sedation and peripheral neurological manifestations of toxicity.
Interventions
DRUGDexmedetomidine and bupivacaine
10 micrograms of dexmedetomidine plus 12,5 mgrs of bupivacaine subarachnoideal
25 micrograms of fentanyl plus 12,5 mgrs of bupivacaine subaracnoideal
Sponsors
Hospital Central Dr. Luis Ortega
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* ASA I and II * lower abdominal surgery
Exclusion criteria
* Consumption antagonists adrenergic or channel blockers Ca ++ * Patients with arrhythmias or heart block * Allergic to any drugs under study * Obese * Physical or mental incapacity to understand and use the pain scale * Contraindication for anesthesia conductive * Realization difficulty or complication during anesthesia and / or surgery
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Changes of motor block using Bromage scale | during anesthesia and 1 hour of postoperatory |
| Changes of baseline blood pressure | during anesthesia and 1 hour of postoperatory |
| Changes of baseline cardiac rate | during anesthesia and 1 hour of postoperatory |
| Changes of baseline oxygen saturation | during anesthesia and 1 hour of postoperatory |
| Postoperatory pain visual analogue scale | during first 24 hours of postoperatory |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Numbers of patients with hypotension using non invasive blood presure monitor | during anesthesia and first 24 hours of postoperatory | we report hypotension below 20% of basal values |
| Numbers of patients with excessive sedation using Ramsay scale | during anesthesia and first 24 hours of postoperatory | — |
| Numbers of patients with nauseas | during anesthesia and first 24 hours of postoperatory | — |
Other
| Measure | Time frame | Description |
|---|---|---|
| Numbers of patients with signs of peripheral neurological toxicity using questionnaire | during first seven days of postoperatory time | phone contact |
Outcome results
None listed