Abstract Dexmedetomidine is a highly selective á 2adrenoreceptor agonist recently introduced to anesthesia. It produces dose dependent sedation, anxiolysis and analgesia without respiratory depression. Methods: This prospective randomized doubleblind study was carried out on 100 patients, aged 20 to 70 years with American society of Anesthesiology (ASA) class I and II of either gender, for lower limb surgery, who met the inclusion criteria of spinal anesthesia. The randomly selected patients received Bupivacaine 0.5% 15 mg (3ml) + 0.5 ml of normal saline in group BS (n=50) and Bupivacaine 0.5% 15 mg (3ml) +Dexmedetomidine 10 mcg in 0.5ml NS in group BD(n=50). The onset time to reach sensory and motor level, the regression time of sensory and motor block, requirement of first rescue analgesic, hemodynamic changes and sideeffects if any were recorded. Result: The onset time to reach T10 dermatome and modified bromage 3 motor blocks were not significantly different between the groups. Time to achieve sensory regression to L1 in Group BD (284.4±62.84 min) were prolonged as compare to Group BS (149.3±24.91min) (p=0.00). The regression time of motor block to reach modified bromage 0 was (379.5±75.42 min) and (231.6 ±44.55 min) in group BD and BS respectively (p=0.004). The first rescue analgesic was required at 200.90 ± 40.33 min and 327.60 ± 60.05 min in group BS and group BD respectively, were comparable (p=0.104). Conclusion: Intrathecal Dexmedetomidine as an adjuvant to intrathecal Bupivacaine prolong sensory and motor block with minimal side effects. So it is an attractive alternative choice for long duration surgery.
Keywords: Bupivacaine; Dexmedetomidine; Lower Limb Surgery; Spinal Anesthesia.