A comparative study of two doses of intrathecal dexmedetomidine 10 mcg and 15 mcg as adjuvants to 0.5% hyperbaric bupivacaine for abdominal hysterectomy: a randomized, prospective, double blind study


  • Anjali R. Bhure Department of Anaesthesiology, NKPSIMS, Nagpur, Maharashtra, India
  • Ketaki S. Marodkar Department of Anaesthesiology, NKPSIMS, Nagpur, Maharashtra, India
  • Sumita Bhargava Pramanik Department of Anaesthesiology, NKPSIMS, Nagpur, Maharashtra, India




Intrathecal dexmedetomidine, Neuraxial adjuvants, Hyperbaric Bupivacaine, Abdominal hysterectomy


Background: Neuraxial adjuvants have been used with local anaesthetics to avoid intraoperative pain, prolong the duration of anaesthesia, and avoid side effects and to provide adequate postoperative analgesia. Dexmedetomidine, a highly selective α2-agonist drug, is being routinely used nowadays as a neuraxial adjuvant. The aim of this study was to compare two doses of dexmedetomidine in terms of efficacy in prolonging the subarachnoid block as well as safety.

Methods: In this prospective, randomized, double-blind, controlled study on 90 ASA I/II patients undergoing elective abdominal hysterectomy patients were randomly allocated to one of the three groups of 30 each, to receive subarachnoid block with 3.4 ml of 0.5% hyperbaric Bupivacaine along with either normal saline (S) or dexmedetomidine 10 µg (D 10) or dexmedetomidine 15 µg (D 15) and onset and duration of motor and sensory block were monitored along with two segment regression times, postoperative VAS scores and analgesic requirements and occurrence of any untoward effects.

Results: Dexmedetomidine significantly decreased the onset times of sensory and motor blocks, prolonged time to two segment regressions, prolonged regression of motor and sensory blocks and time to first rescue analgesic in postoperative period. There was reduction in requirement of analgesics in both the dexmedetomidine groups. Effects were more pronounced in D 15 group than D 10 group. All three group patients were stable haemodynamically with only an insignificant number of patients having bradycardia and hypotension in the D 15 group.

Conclusions: Thus dexmedetomidine prolongs the 0.5% hyperbaric Bupivacaine spinal anaesthesia duration. Prolongation of anaesthesia is in a dose dependent manner and groups are comparable in terms of safety profiles.


Strebel S, Gurzeler J, Schneider M, Aeschbach A, Kindler C. Small-dose intrathecal clonidine and isobaric bupivacaine for orthopedic surgery: a dose-response-study. Anesth Analg. 2004;99:1231-8.

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 Anaesthesiol Scand. 2006;50(2):222-7.

Schulte-Tamburen AM, Scheier J, Briegel J, Schwender D, Peter K. Comparison of five sedation scoring systems by means of auditory evoked potentials. Intensive Care Med. 1999;25(4):377-82.

Elia N, Culebras X, Mazza C, Schiffer E, Tramèr MR. Clonidine as an adjuvant to intrathecal local anesthetics for surgery: systematic review of randomized trials. Reg Anesth Pain Med. 2008;33:159-67.

Boussofara M, Carlès M, Raucoules-Aimé M, Sellam MR, Horn JL. Effects of intrathecal midazolam on postoperative analgesia when added to a bupivacaine-clonidine mixture. Reg Anesth Pain Med. 2006;31:501-5.

Mohamed AA, Fares KM, Mohamed SA. Efficacy of intrathecally administered dexmedetomidine versus dexmedetomidine with fentanyl in patients undergoing major abdominal cancer surgery. Pain Physician. 2012;15(4):339-48.

Shukla D, Verma A, Agarwal A, Pandey HD, Tyagi C. Comparative study of intrathecal dexmedetomidine and intrathecal magnesium sulphate used as adjuvant to Bupivacaine. J Anaesthesiol Clin Pharmacol. 2011;27(4):495-9.

Abdelhamid SA, Mohamed HE. Intrathecal dexmedetomidine: useful or not? JACR. 2013;4(9):351-5.

Ogan SF, Job OG, Emjindah CE. Comparative effects of single shot intrathecal Bupivacaine with dexmedetomidine and Bupivacaine with Fentanyl on labour outcome. ISRN Anaesthesiolog. 2012;8:169-84.

Hala EA, Eid MD, Mohamed A, Shafie MD, Hend Youssef MD. Dose-related prolongation of hyperbaric bupivacaine spinal anesthesia by dexmedetomidine. Ain Shams Journal of Anesthesiology. 2011;4(2).

Eid HA, Shafie M, Yousef H. Dose related prolongation of hyperbaric Bupivacaine spinal anaesthesia by dexmedetomidine. Ain Shams Journal of Anaesthesiology. 2011;4.




How to Cite

Bhure, A. R., Marodkar, K. S., & Pramanik, S. B. (2017). A comparative study of two doses of intrathecal dexmedetomidine 10 mcg and 15 mcg as adjuvants to 0.5% hyperbaric bupivacaine for abdominal hysterectomy: a randomized, prospective, double blind study. International Journal of Basic & Clinical Pharmacology, 5(5), 2215–2221. https://doi.org/10.18203/2319-2003.ijbcp20163264



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