Comparing Doses of Intrathecal Dexmedetomidine Along With Bupivacaine for Cesarean Section: A Double-Blind Randomized Clinical Trial

Abstract

Objective:
To compare the duration of sensory and motor blockade produced by two different intrathecal doses of dexmedetomidine (5 µg and 10 µg) when added to hyperbaric bupivacaine in patients undergoing elective cesarean section.

Study Design:
Prospective, double-blind, randomized clinical trial.

Place and Duration of Study:
Department of Anesthesiology, Bahria International Hospital, Rawalpindi, conducted over a period of three months following approval from the College of Physicians and Surgeons Pakistan (CPSP) and the institutional ethical review board.

Methodology:
Sixty ASA II parturients aged between 20 and 40 years scheduled for elective cesarean section under spinal anesthesia were enrolled. Patients were randomized into two equal groups (n=30 each). Group A received 5 µg dexmedetomidine with 12.5 mg of 0.5% hyperbaric bupivacaine, while Group B received 10 µg dexmedetomidine with the same dose of bupivacaine. Duration of sensory and motor blockade were recorded as primary outcomes. Hemodynamic parameters including heart rate and mean arterial pressure were recorded as secondary outcomes. Statistical analysis was performed using SPSS version 26.

Results:
The mean duration of sensory blockade was significantly longer in Group B (351.2 ± 46.8 minutes) compared to Group A (286.4 ± 52.3 minutes) (p < 0.001). Similarly, the duration of motor blockade was significantly prolonged in Group B (361.5 ± 15.9 minutes) compared to Group A (312.1 ± 29.7 minutes) (p < 0.001). Hemodynamic parameters remained stable in both groups, with no statistically or clinically significant adverse effects observed.

Conclusion:
Intrathecal dexmedetomidine at a dose of 10 µg significantly prolongs the duration of sensory and motor blockade compared to 5 µg when used as an adjuvant to hyperbaric bupivacaine for elective cesarean section, without compromising maternal hemodynamic stability.

Keywords:
Dexmedetomidine, spinal anesthesia, cesarean section, bupivacaine, sensory block, motor block