Singh Atul Kumar, Singh Yashpal, Jain Gaurav, Verma Ravi Kumar
Department of Anaesthesiology and Intensive Care, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Anesth Essays Res. 2015 Sep-Dec;9(3):343-7. doi: 10.4103/0259-1162.158009.
To augment the subarachnoid block utility, the efficacy of newer molecules as an adjuvant is investigated constantly. Considering the favorable profile of dexmedetomidine, it could have a potential role as an adjuvant to ropivacaine.
We evaluated the efficacy of two different doses of dexmedetomidine as an adjuvant to isobaric ropivacaine, intrathecally.
Ninety patients scheduled for lower abdominal surgery under spinal anesthesia were randomized into three groups to receive 2.5 ml of isobaric ropivacaine (0.75%, 7.5 mg/ml) added to 5 µg (10 µg/ml) or 10 µg (20 µg/ml) of dexmedetomidine or 0.5 ml of normal saline in group A, B or C, respectively. Block characteristics were compared as a primary outcome.
One-way analysis of variance test, Fisher's exact test/Chi-square test, whichever appropriate. A P < 0.05 was considered significant.
Time to achieve desired block was least in group B and maximum in group C. The sensory-motor blockade remained significantly prolonged in group B compared to other groups. Hemodynamic parameters remained stable in all three groups.
Among the investigated doses, dexmedetomidine augments the efficacy of intrathecal ropivacaine in a dose-dependent manner, without any untoward side effects.
为增强蛛网膜下腔阻滞的效用，人们不断研究新型分子作为佐剂的疗效。鉴于右美托咪定的良好特性，它可能具有作为罗哌卡因佐剂的潜在作用。
我们评估了两种不同剂量的右美托咪定作为等比重罗哌卡因鞘内注射佐剂的疗效。
将90例计划在脊髓麻醉下进行下腹部手术的患者随机分为三组，分别在A组、B组或C组接受添加了5μg（10μg/ml）或10μg（20μg/ml）右美托咪定的2.5ml等比重罗哌卡因（0.75%，7.5mg/ml）或0.5ml生理盐水。将阻滞特征作为主要结局进行比较。
采用单因素方差分析检验、Fisher精确检验/卡方检验，视情况而定。P<0.05被认为具有统计学意义。
达到所需阻滞的时间在B组最短，在C组最长。与其他组相比，B组的感觉-运动阻滞持续时间明显延长。三组的血流动力学参数均保持稳定。
在所研究的剂量中，右美托咪定以剂量依赖的方式增强鞘内注射罗哌卡因的疗效，且无任何不良副作用。
