Postoperative analgesic effect of intrathecal dexmedetomidine on bupivacaine subarachnoid block for open reduction and internal fixation of femoral fractures

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Postoperative analgesic effect of intrathecal dexmedetomidine on bupivacaine subarachnoid block for open reduction and internal fixation of femoral fractures


JournalNigerian Journal Of Clinical Practice
Publication date – Feb – 2020
Authors – C Nwachukwu, H O Idehen, N P Edomwonyi, B Umeh
KeywordsIntrathecal dexmedetomidine, open reduction and internal fixation, postoperative pain., subarachnoid block.
Open access – Yes
SpecialityAnaesthesia, Trauma and orthopaedic surgery, Trauma surgery
World region Western Africa
Country: Nigeria
Language – English
Submitted to the One Surgery Index on May 21, 2020 at 8:52 am
Abstract:

Background
One of the drawbacks of subarachnoid block is the short duration of analgesia particularly when adjuvants are not added to local anesthetics agent used. However, dexmedetomidine an α2-adrenergic agent has been found to possess analgesic effect.
Aims
This study seeks to determine the analgesic efficacy of intrathecal 7.5 μg of dexmedetomidine and its side effects when used for open reduction and internal fixation (ORIF) of femoral fractures.
Methodology
It is a prospective randomized, double-blinded study that was carried out in a Nnamdi Azikiwe University Teaching Hospital, Nnewi in Nigeria. Seventy American Society of Anesthesiologists I or II patients were randomized into two groups of 35 each to receive 3 ml of 0.5% hyperbaric bupivacaine combined with either 7.5 μg of dexmedetomidine in 0.3 ml of normal saline (Group D) or 0.3 ml of normal saline alone (Group S). Patient’s outcome measures noted (time to first request of analgesia, proportion of patients with pain score <4 postoperatively using numerical rating scale [NRS], and total analgesic consumed in 24 h.).
Results
The patients in Group D had a longer time to first request of analgesia, larger proportion of patients with pain score 0.05). However, the patient satisfaction was better in Group D.
Conclusion
The addition of 7.5 μg of dexmedetomidine to bupivacaine for subarachnoid block in the management of femoral fractures using ORIF provided better anesthetic profile, particularly prolonged duration of postoperative analgesia without significant side effects.

OSI Number – 20396
PMID – 3203109

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