EVALUATION OF EFFICACY OF DEXMEDETOMIDINE AS AN ADJUVANT TO LIGNOCAINE DURING INTRAVENOUS REGIONAL ANAESTHESIA
Abstract
Background and Aim- Intravenous regional anaesthesia (IVRA) is technically, reliable, simple and safe method of providing anaesthesia for minor surgical procedures over the upper extremities. Various local anaesthetic agents like lignocaine, bupivacaine, mepivacaine and procaine have been used for IVRA. The purpose and aim of the present study was to assess the efficacy of 0.5µg/kg dexmedetomidine as an adjuvant to lignocaine during IVRA with regard to Onset & duration of sensory block and motor block ,Efficacy , duration of analgesia,Degree of sedation ,Incidence of tourniquet pain , Haemodynamic variables and patient acceptance .
Method-Total 60 patients of ASA grade I&II scheduled for elective surgery of upper limb, were randomized into two groups for IVRA .Group L Patients were received 0.9% normal saline plus 3mg/kg lignocaine (0.5%) diluted with normal saline upto total dose of 40 ml and Group LD Patients were received 0.5µg/kg dexmedetomidine plus 3mg/kg lignocaine (0.5%) diluted with normal saline up to total dose of 40 ml. All patient in two groups were assessed for sensory block, motor block, sedation and monitored for hemodynamics, intraoperative and postoperative analgesia using VAS score and side effect if any.
Results VAS Score was significant lower, when compared both groups, there was a significant shorter sensory onset and longer recovery time observed in LD group and onset of motor block faster and regression of motor block was slower in LD group in IVRA. Sedartion Score more in group LD significantly and number of rescue analgesia given in postop was lower in group LD.
Conclusion- Dexmedetomidine addition to lignocaine in IVRA improved the quality of both sensory and motor block with good quality of analgesia. It enhanced the duration of postoperative analgesia and was not associated with haemodynamic instability or any other complications.
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Vishma K, Divya Vincentt. Comparison of 0.5% Lignocaine with Tramadol and with Nalbuphine for Day Care IVRA in Upper Limb. Dental Medical Sciences. 2016; 15: 99-105
Shilpashri A. M, Kavya K. G, Priodarshi Roychoudhury. Dexmedetomidine as an adjunct to 0.5% lignocaine for intravenous regional anaesthesia for upper limb surgeries. Evidence based Medicine Healthcare. 2015; 2: 5171-78.
David Flamer, Philip WH Peng. Intravenous regional anaesthesia: a review of common local anesthetic options and the use of opioids and muscle relaxants as adjuncts. Local Reg Anesth. 2011; 4: 57–76.
Huseyin Sen, Kuiahci, Yalcin. Analgesic effects of paracetamol when added to lignocaine in intravenous regional anaesthesia. 2009:109; 1327-30.
Ruben SS, Steinberg RB, Kreitzer JM, Duprat KM. Intravenous regional anaesthesia using lidocaine and ketorolac (NSAID). Anesth Analg. 1995; 81 : 110-3.
Armstrong P, Power I, Wildsmith JA. Addition of fentanyl to prilocaine for intravenous regional anaesthesia. 1991 ; 46 : 278-80.
Sethi D, Will beon R. Intravenous regional anaesthesia using lidocaine and neostigmine for upper limb surgery. J Clin. Anesth. 2010; 22: 324-8.
Esmaoglu A , Akin A , Mizrak A ,Turk Y. Addition of cisatracurium to lidocaine for Intravenous regional anaesthesia. J Clin Anaesth. 2006 ; 18:194-7.
Kamibayashi T, Maze M. Clinical uses of alpha adrenergic agonists Anaesthesiolog. 2000; 93 :1345-9.
Aho MS, Erkola OA, Kallio A, et al. Dexmedetomidine infusion for maintenance of anesthesia in patients undergoing abdominal hysterectomy. Anesth Analg . 1992; 75: 940–6.
Jaakola ML, Ali-Melkkila T, Kanto J, et al. Dexmedetomidine reduces intraocular pressure in intubation responses and anaesthetic requirements in patients undergoing ophthalmic surgery. Br J Anaesth. 1992 ; 68: 570–5.
Kalso EA, Poyhia R, Rosenberg PH. Spinal antinociception by dexmedetomidine, a highly selective α2 adrenergic agonist. Pharmacol Toxicol. 1991; 68: 140–3.
Aho MS, Erkola OA, Scheinin H, et al. Effect of intravenously administered dexmedetomidine on pain after laparoscopic tubal ligation. Anesth Analg. 1991; 73: 112–8.
Goel S, Daftary S, Panavaidya S. Intravenous Regional Anaesthesia using tramadol hydrochloride and ketorolac. A double blind control study. Ind J Anaesthesia 2002;46:369-372.
Memis D, Turan A, Karamanlioglu B, Pamukcuz, KurtI. Addition of dexmeditomidine to lignocaine for intravenous regional anaesthesia. Anesth Analg. 2004 ;94: 835-40
A. Esmaoglu, A. Mizrak, A. Akin. Addition of dexmeditomidine to lignocaine for intravenous regional anaesthesia. Eur J Anaesthesiol. 2005; 22: 447-451.
G Mir, A Naqeeb, T Waani, A Shora. Intravenous Regional Anaesthesia with drug combinations of Lidocaine, Ketamine, and Atracurium. The Internet Journal of Anesthesiology. 2007; 18: 1-6.
ESha Nileknai, Yvonne Menezes, Shirley Ann D’Souza, A Study on the Efficacy of the Addition of Low Dose Dexmedetomidine as an Adjuvant to Lignocaine in Intravenous Regional Anaesthesia, Journal of Clinical and Diagnostic Research. 2016; 10: UC01-UC05.
Jewlikar S , Suryawanshi A. Comparative study of 0.5% lignocaine with dexmedetomidine and 0.5% lignocaine in intravenous regional anesthesia. International J Anaesthesiology. 2017; 3: 66-70.
Bharti Gupta, Ravinder Kumar Verma, Sudershan Kumar, and Geeta Chaudhary. Comparison of Analgesic Efficacy of Dexmedetomidine and Midazolam as Adjuncts to Lignocaine for Intravenous Regional Anesthesia. Anesth Essays Res. 2017 ;11: 62–66.
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