AI Article Synopsis
- The study aimed to compare the effectiveness of intravenous dexmedetomidine versus a combination of low-dose ketamine and dexmedetomidine for extending spinal anesthesia in lower limb orthopedic surgeries.
- Conducted on 60 patients, the study divided them into two groups: one receiving only dexmedetomidine (Group D) and the other receiving a mix of ketamine and dexmedetomidine (Group LKD).
- Results showed similar anesthesia duration between groups, but Group D experienced more hypotension episodes, while Group LKD required less tramadol post-surgery.
Article Abstract
Background And Aims: One major limitation of the spinal block remains the inability to extend the duration of the block intraoperatively unless planned before with spinal or epidural catheters and/or intrathecal additives. This study was designed to compare the effects of intravenous dexmedetomidine versus low-dose ketamine-dexmedetomidine combination infusion on spinal anaesthesia in lower limb orthopaedic surgeries.
Methods: This randomised study was conducted in 60 patients scheduled for unilateral lower limb surgeries under spinal anaesthesia. Patients were randomised into Group D ( = 30) (0.5 µg/kg of intravenous (IV) dexmedetomidine bolus followed by maintenance infusion at 0.5 µg/kg/h) and Group LKD ( = 30) (IV bolus of 0.5 µg/kg of dexmedetomidine and 0.2 mg/kg of ketamine, followed by maintenance infusions of dexmedetomidine and ketamine at 0.5 µg/kg/h and 0.2 mg/kg/h, respectively). Ramsay Sedation Scale score of 3-4 was maintained. The -test or the Wilcoxon-Mann-Whitney test was used to compare the parameters between groups.
Results: The mean sacral segment 1 (S1) regression time was 390.3 [standard deviation (SD):84.38] [95% confidence interval (CI): 360.13, 420.53] versus 393.23 (SD: 93.01) (95% CI: 363.04, 423.43) min in Group D versus Group LKD respectively (( = 0.701). The number of episodes of hypotension was significantly higher in Group D (19 patients) compared to Group LKD (nine patients) ( = 0.001). Pre- and postoperative stress markers (24 h) and the incidence of postoperative nausea and shivering were comparable between the two groups ( > 0.05). Tramadol requirement in the postoperative period was significantly less in Group LKD compared to Group D ( = 0.003).
Conclusion: The duration of S1 regression was similar between group dexmedetomidine (Group D) and group low-dose ketamine and dexmedetomidine (Group LKD).
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460815 | PMC |
| http://dx.doi.org/10.4103/ija.ija_14_24 | DOI Listing |
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