Year : 2016  |  Volume : 10  |  Issue : 1  |  Page : 18-24

Effects of perineural administration of dexmedetomidine in combination with bupivacaine in a femoral-sciatic nerve block

1 Department of Anesthesiology, Faculty of Medicine, Menoufia University, Shebin El Kom, Menoufia, Egypt
2 Department of Anesthesiology, King Fahd Hospital of the University of Dammam, Al Khobar, Saudi Arabia

Correspondence Address:
Ihab S Gaarour
Department of Anesthesiology, King Fahd Hospital of the University of Dammam, Al Khobar, P.O. 40124, Al Khubar 31952
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1658-354X.169469

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Background and Aim: Perineural administration of dexmedetomidine, a α2-adrenoceptor agonist, prolongs the duration of analgesia. We hypothesized that adding dexmedetomidine to bupivacaine would prolong postoperative analgesia after below knee surgery. Materials and Methods: After ethical approval, 60 patients scheduled for below knee surgery under combined femoral-sciatic nerve block were randomly allocated into two groups to have their block performed using bupivacaine 0.5% alone (group B) or bupivacaine 0.5% combined with 100 μg bupivacaine-dexmedetomidine (group BD). Motor and sensory block onset times; durations of blockades and analgesia were recorded. Results: Sensory and motor block onset times were shorter by 20% in group BD than in group B (P < 0.01). Sensory and motor blockade durations were longer in group BD (+45% and +40%, respectively) than in group B (P < 0.01). Duration of analgesia was longer in group BD by 75% than in group B (P < 0.01). Systolic, diastolic arterial blood pressure levels, and heart rate were significantly less in group BD, six patients in group BD, and no patients in group B developed bradycardia (P < 0.05). Conclusion: The addition of dexmedetomidine 100 μg to bupivacaine 0.5% during ultrasound-guided combined femoral and sciatic block for below knee surgery was associated with a prolonged duration of analgesia. However, this may be associated with significant bradycardia requiring treatment.

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