右美与镇痛2018-1-29.pptxVIP

右美托咪定与镇痛;主要内容;A comparative study between intrathecal dexmedetomidine and fentanyl as adjuvant to intrathecal bupivacaine in lower abdominal surgeries: A randomized trial;Context: Spinal anesthesia is preferred choice of anesthesia in lower abdominal surgeries since long time. However problem with this is limited duration of action, so for long duration surgeries alternative are required. Dexmedetomidine is a highly selective alpha-2-adrenergic agonist has property to potentiate the action of local anesthetic used in spinal anesthesia. Fentanyl is an opioid and it has also the same property. ;Aims: To compare the efficacy, analgesic effects, and side effects of dexmedetomidine and fentanyl as adjuvant to bupivacaine for lower abdominal surgery. Subjects and Methods: After obtaining clearance from ethical committee, the enrolled patients were randomized in two groups of 40 patients each (n = 40) using random number table. Group D: Patients receiving bupivacaine with dexmedetomidine. Group F: Patients receiving bupivacaine with fentanyl. ; All the patients in both the groups were premedicated with tablet diazepam 5 mg, tablet rantac 150 mg, night prior to surgery. Record: BP, HR, SpO2 T1 = Immediately before dural puncture for spinal anesthesia T2 = Immediately after dural puncture for spinal anesthesia T3 to T26 = Every 5 min thereafter for 120 min. The sensory dermatome level was assessed by pin prick sensation using 23 gauge hypodermic needle along the mid clavicular line bilaterally. The sensory level and Bromage scale were recorded every 2 min after the spinal injection up to the 10 min and after that every 10 min until the highest dermatome was reached. In the postanesthesia care unit (PACU), the sensory level and Bromage scale were recorded every 10 min until the patient was discharged from the PACU. ;;Diastolic blood pressure at different time intervals;Change in heart rate within group at different time intervals from baseline (before dural puncture);Hig