The effects of intravenous Dexmedetomidine on sedation and postoperative analgesia duration during spinal anesthesia with isobaric Levobupivacain

Purpose: The effects of intravenous dexmedetomidine on sedation and the motor and sensory blockade durations were studied in the patients undergoing transurethral surgery under spinal anesthesia.Material and Method: After the written consents of the patients and the Ministry of Health General Directorate of Pharmaceuticals and Pharmacy were taken the prospective and doubleblind study was carried out on 50 patients undergoing elective transurethral surgery under spinal anesthesia. The patients were seperated into two groups of 25 randomly. After the spinal anesthesia with levobupivacaine of 5 % was applied, Group DX was received 1 µgr/kg of dexmedetomidine intravenous in 10 minutes and then maintenance infusion of 0.5 µgr/kg/hour. Group SF was given saline solution (same volume as dexmedetomidine) infusion.Heart rate, systolic and diastolic arterial pressures, pain and sedation scores, the level and duration of motor and sensory blocks, recovery and patient comfort scores, nausea, vomiting and the other possible side effects in the postoperative period were recorded in the 5th, 10th, 15th, 20th, 30th, 45th, 60th, 90th, 105th, 120th, 135th, 150th, 165th, and 180th minutes.Results: No statistically differences were found between the groups in any measurement time when they were compared in terms of Modified Bromage Score. While the sensory block onset time of the groups did not differ, it was seen that the level of sensory block in Group DX was statistically higher compared to Group SF in the 5th, 10th, 15th, 20th, 45th, 60th, 90th, 105th, 120th, 135th, 150th, 165th, and 180th minutes. When the groups were compared in terms of the durations of reaching the maximal block levels, it was found that the duration was statistically longer in Group DX compared to Group SF. No statistically difference was found between the averages of two segment regression duration of sensory blocks of groups. While the duration of Modified Bromage Scores of the groups to reach 0 were similar, the average spinal anesthesia duration was statistically longer in Group DX compared to Group SF. Ramsey Sedation Score was found to be statistically higher in Group DX compared to Group SF on the intraoperative 5th, 10th, 15th, 30th minutes and on the postoperative 10th and 15th minutes. No statistically meaningful difference was found between the groups in terms of postoperative nausea and vomiting score evaluations, in the same periods. The frequency of bradycardia and hypotension, the most frequent side effects, were comparable between the groups. No statistically difference was found between the groups in terms of postoperative recovery score and patient comfort evaluations which were done in the same periods.Results: In patients undergoing transurethral surgery under spinal anesthesia applied with 0.5 % levobupivacaine, it was found that sensory block onset time, two segment regression duration, the duration of motor block, the duration of Modified Bromage Scores being 0, nausea and vomiting frequency, postoperative recovery and on the patient comfort were similar between the groups. The sensory block levels were found to be statistically higher in group DX compared to group SF in the 5th, 10th, 15th, 20th, 45th, 60th, 90th, 105th, 120th, 135th, 150th, 165th, and 180th minutes. When the groups were compared in terms of the times in reaching the maximal block level, it was found that it was statistically higher in group DX compared to group SF. Ramsey Sedation Score values were found to be statistically higher in group DX compared to group SF in the intraoperative 5th, 10th, 15th and 30th minutes and in the postoperative 10th and 15th minutes.Key words: Dexmedetomidine, Sedation, Spinal Anesthesia, Transurethral Surgery