The effects of dexmedetomidine added to spinal levobupivacaine for transurethral endoscopic surgery

The effects of dexmedetomidine added to spinal levobupivacaine for transurethral endoscopic surgery

Background: Intrathecal α2 agonists prolong the duration of action of local anesthetics and reduce the required dose. Dexmedetomidine is an α2 recep- tor agonist and its α2/α1 selectivity is 8 times higher than that of clonidine. Aims: In this study, we aimed to investigate the effect of adding dexmedetomidine to intrathecal levobupivacaine on the onset time and duration of motor and sensory blocks. Study Design: Randomized controlled study. Methods: Patients were randomly assigned into two groups. Group L (n= 30) patients received 3 mL (15 mg) of 0.5% levobupivacaine +0.3 mL normal saline and Group LD (n= 30) patients received 3 mL (15 mg) of 0.5% levobupivacaine + 0.3 mL (3 μg) dexmedetomidine. Sensory block onset time, block reaching time to T10 dermatome, the most elevated dermatome level, two dermatome regression time, sensory block complete regression time as well as motor block onset time, reaching Bromage 3 and regressing to Bromage 0 were recorded. Results: Sensory and motor block onset times were shorter in Group LD than in Group L (p

___

  • 1. Strebel S, Gurzeler JA, Schneider MC, Aeschbach A, Kindler CH. Small-dose intrathecal clonidine and isobaric bupivacaine for orthopedic surgery: a dose-response-study. Anesth Analg 2004;99:1231-38. [CrossRef]
  • 2. Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R, et al. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Acta Anaesth Scand 2006;50:222-7. [CrossRef]
  • 3. Kalso E, Poyhia R, Rosenberg P. Spinal antinociception by dexmedetomidine, a highly selective alpha 2- adrenergic agonist. Pharmacol Toxicol 1991;68:140-3. [CrossRef]
  • 4. Foster RH, Markham A. Levobupivacaine: A Review of its pharmacology and use as a local anaesthetic. Drugs 2000;59:531-79. [CrossRef]
  • 5. Bromage PR. Epidural Anesthesia. Philadelphia, WB Saunders, 1978, 144.
  • 6. Ossipov MH, Suarez LJ, Spaulding TC. Antinociceptive interactions between alpha 2 adrenergic and opiate agonists at the spinal level in rodents. Anesth Analg 1989;68:194-200. [CrossRef]
  • 7. Hood DD, Mallak KA, Eisenach JC, Tong C. Interaction between intrathecal neostigmine and epidural clonidine in human volun-teers. Anesthesiology 1996;85:315-25. [CrossRef]
  • 8. Eisenach JC, De Kock M, Klimscha W. alpha (2)-adrenergic agonists for regional anesthesia. A clinical review of clonidine (1984- 1995). Anesthesiology 1996;85:655-74. [CrossRef]
  • 9. De Kock M, Gautier P, Fanard L, Hody JL, Lavand’homme P. Intrathecal ropivacaine and clonidine for ambulatory knee arthroscopy: a dose-response study. Anesthesiology 2001;94:574-8. [CrossRef]
  • 10. Dobrydnjov I, Axelsson K, Samarütel J, Holmström B. Postoperative pain relief following intrathecal bupivacaine combined with intrathecal or oral clonidine. Acta Anaesthesiol Scand 2002;46:806-14. [CrossRef]
  • 11. Eisenach JC, Shafer SL, Bucklin BA, Jackson C, Kallio A. Pharmacokinetics and pharmacodynamics of intraspinal dexmedetomidine in sheep. Anesthesiology 1994;80:1349-59. [CrossRef]
  • 12. Talke P, Xu M, Paloheimo M, Kalso E. Effects of intrathecally administered dexmedetomidine, MPV-2426 and tizanidine on EMG in rats. Acta Anaesthesiol Scand 2003;47:347-54. [CrossRef]
  • 13. Xu M, Kontinen VK, Kalso E. Effects of radolmidine, a novel alpha2- adrenergic agonist compared with dexmedetomidine in different pain models in the rat. Anesthesiology 2000;93:473-81. [CrossRef]
  • 14. Horvath G, Joo G, Dobos I, Klimscha W, Toth G, Benedek G. The synergistic antinociceptive interactions of endomorphin-1 with dexmedetomidine and/or S(+)-ketamine in rats. Anesth Analg 2001;93:1018-24. [CrossRef]
  • 15. Onttonen T, Pertovaara A. The mechanical antihyperalgesic effect of intrathecally administered MPV-2426, a novel alpha2-ad-renoceptor agonist, in a rat model of postoperative pain. Anesthesiology 2000;92:1740-5. [CrossRef]
  • 16. Takano Y, Yaksh TL. Characterization of the pharmacology of intrathecally administered alpha 2-agonists and antagonists in rats. J Pharmacol Exp Ther 1992;261:764-72.
  • 17. Al-Mustafa MM, Abu-Halaweh SA, Aloweidi AS, Murshidi MM, Ammari BA, Awwad ZM, et al. Effect of dexmedetomidine added to spinal bupivacaine for urological procedures. Saudi Med J 2009;30:365-70.
  • 18. Al-Ghanem SM, Massad IM, Al-Mustafa MM, Al-Zaben KR, Qudaisat IY, Qatawneh AM, et al. Effect of Adding Dexmedetomidine versus Fentanyl to Intrathecal Bupivacaine on Spinal Block Characteristics in Gynecological Procedures: A Double Blind Controlled Study. Am J Appl Sci 2009;6:882-7. [CrossRef]
  • 19. Gupta R, Bogra J, Verma R, Kohli M, Kushwaha JK, Kumar S. Dexmedetomidine as an intrathecal adjuvant for postoperative analgesia. Indian J Anaesth 2011;55:347-51. [CrossRef]
  • 20. Gupta R, Verma R, Bogra J, Kohli M, Raman R, Kushwaha JK. A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to Bupivacaine. J Anaesthesiol Clin Pharmacol 2011;27:339-43. [CrossRef]
  • 21. Calasans-Maia JA, Zapata-Sudo G, Sudo RT. Dexmedetomidine prolongs spinal anaesthesia induced by levobupivacaine 0.5% in guinea-pigs. J Pharm Pharmacol 2005;57:1415-20. [CrossRef]
  • 22. Santiveri X, Arxer A, Plaja I, Metje MT, Martínez B, Villalonga A, et al. Anaesthetic and postoperative analgesic effects of spinal clonidine as an additive to prilocaine in the transurethral resection of urinary bladder tumours. Eur J Anaesth 2002;19:589-93. [CrossRef]
  • 23. Niemi L. Effects of intrathecal clonidine on duration of bupivacaine spinal anaesthesia, haemodynamics and postoperative analgesia in patients undergoing knee arthroscopy. Acta Anaesthesiol Scand 1994;38:724-8. [CrossRef]
Balkan Medical Journal-Cover
  • ISSN: 2146-3123
  • Başlangıç: 2015
  • Yayıncı: Erkan Mor
Sayıdaki Diğer Makaleler

Neuropeptide Y gene promoter -399T/C polymorphism increases risk of ischemic stroke

Xin ZHANG, Xue-Feng FU, Dong-Jun WANG, Yu-Rong LI, Bo ZHAO

Vocal fold hyperplastic lesions: An evaluation of surgical outcome with videolaryngostroboscopy

Ertuğrul ÇOLAK, Armağan İNCESULU, Melek Kezban GÜRBÜZ, Leman BİRDANE, Erkan ÖZÜDOĞRU, Cemal CİNGİ, Mustafa Fuat AÇIKALIN

Detection of OXA-48-like carbapenemase-producing Klebsiella pneumoniae in a Tertiary Care Center in Turkey: Molecular characterization and epidemiology

Barış OTLU, Yusuf YAKUPOĞULLARI, Özlem AZAP, Ayşegül YEŞİLKAYA

Recent Changes to the Balkan Medical Journal

Cem UZUN

Pityriasis rosea associated with pegylated interferon alfa and ribavirin treatment in a patient with chronic hepatitis C

İmran HASANOĞLU, Şiran KESKE, Mehmet TAŞYARAN, Rahmet GÜNER

Abdominal wall endometrioma: Ultrasonographic features and correlation with clinical findings

Taylan Özgür SEZER, İlhami SOLAK, Aynur SOLAK, Berhan GENÇ, Neslin ŞAHİN, Seyhan YALAZ

The evaluation of saliva flow rate, pH, buffer capacity, microbiological content and indice of decayed, missing and filled teeth in Behçet’s patients

Mehmet YILDIZ, Teoman ERDEM, Vildan ERDEM

Triptolide as an alternative to IVIG therapy for Kawasaki disease in a mouse model

Zong-Ting YAN, Jian-Wen ZOU

Diagnosis, treatment and outcomes of patients with Aortopulmonary window

Fadli DEMİR, Türkay SARITAŞ, Nurdan EROL, İlker Kemal YÜCEL, İbrahim Halil DEMİR, Ahmet ÇELEBİ, Numan Ali AYDEMİR, Abdullah ERDEM

The effects of dexmedetomidine added to spinal levobupivacaine for transurethral endoscopic surgery

Adnan BAYRAM, Ayşe ÜLGEY, Aynur AKIN, Aliye ESMAOĞLU, Fatih UĞUR, Sümeyra TÜRK