Comparison of Bupivacaine Alone versus Low Dose Bupivacaine and Dexmedetomidine in Elderly Male Patients undergoing Genitourinary Surgery Under Spinal Anesthesia

Abstract

Objective: To compare motor and sensory blockade and hemodynamic effects of standard dose Bupivacaine versus low dose
Bupivacaine mixed with Dexmedetomidine for spinal anesthesia in elderly male patients undergoing genitourinary surgery.

Study Design: Prospective comparative study.

Place and Duration of Study: Anesthesia Department Combined Military Hospital, Lahore Pakistan, from Sep 2019 to Feb
2020.

Methodology: Hundred elderly male patients of American Society of Anesthesiology status-II undergoing surgery under
spinal anesthesia were divided in two Groups. Group B (Bupivacaine Group) was given 11.25mg Bupivacaine and Group BD
(Bupivacaine+Dexmedetomidine Group) received 7.5mg Bupivacaine and 5µg Dexmedetomidine intrathecally. Both Groups
were given equal volume of 2ml.

Results: Mean time for onset of sensory block for Group B and BD was 2.72±0.81 and 2.28±1.03 minutes respectively (pvalue=0.02). Mean time for onset of motor block for Group B and BD was 3.09±0.62 and 2.84±0.64 minutes respectively (pvalue=0.045). Mean duration of analgesia in Group B and BD was 171.87±10.19 and 187.60±18.42 minutes (p-value=0.01). Mean heart rate in Group B and BD was 80.04±5.51 and 75.68±6.11 beats/minutes (p-value=0.001). Mean arterial pressure’s mean in
Group B and BD was 62.78±78.13.49 and 87.96±10.15 (p-value=0.001).

Conclusion: Onset of sensory and motor block was significantly shorter; analgesic effect was longer when Dexmedetomidine
was combined with Bupivacaine for spinal anesthesia in comparison to Bupivacaine alone. Hemodynamic complications were
also less in combination approach.