Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Anaesthesia

Spinal anaesthesia is used commonly intra operatively. However, local anaesthetics are associated with relatively short duration of action. A number of adjuvants have been used to prolong the postoperative analgesia. To evaluate role of dexmedetomidine added to heavy bupivacaine 0.5% intrathecally for lower abdominal surgeries. This double-blind study included eighty ASA I or II patients, aged between 20 and 50 years old, scheduled for lower abdominal operations. They were randomly divided into two groups: Group d (Gd) (n = 40): received 3 ml volume of 0.5% hyperbaric bupivacaine (15 mg) and 5 og dexmedetomidine in 0.5 ml of normal saline as intrathecal injection, dexmedetomidine (100 og/ml) was diluted in normal saline, to make a total volume of 3.5 ml intrathecal solution. Group b (Gb) (n = 40): received 3 ml volume of 0.5% hyperbaric bupivacaine (15 mg) and 0.5 ml of normal saline, to make a total volume of 3.5 ml intrathecal solution. The onset time, duration of sensory and motor blocks, the total duration of analgesia and associated side effects were recorded. The study showed that the onset of sensory and motor blocks were significantly earlier in Gd than Gb (p value < 0.05) and the duration of sensory block, motor block and total duration of analgesia were significantly longer in Gd than Gb (p value < 0.05). Also the incidence of occurrence of bradycardia was significantly higher in Gd than Gb (p value < 0.05). There were no statistically significant differences in occurrence of hypotension, nausea and vomiting between two groups. No other complications were recorded in the study

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