DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20181286

A comparative study of intravenous dexmedetomidine and midazolam on prolongation of spinal anesthesia

Malarvizhi T., Vidhya A., Lavanya R.

Abstract


Background: The present study was conducted to compare the efficacy and safety of intravenous dexmedetomidine and midazolam on prolongation of spinal anesthesia.

Methods: The study population included people who were undergoing for spinal anesthesia for various surgeries. A total of 90 subject were randomized equally to Dexmedetomidine, Midazolam and saline groups using a computer generated random number sequence. Three study groups were compared with respect to all the baseline variables. The key outcome parameters and hemodynamic parameters were compared among the three study groups.

Results: No statistically significant differences were observed in baseline paramters across study groups. The median values of patient satisfaction score and anesthesiologist satisfaction score were almost equal among three study groups, but the association was statistically not significant. The median VAS and the median HSL were slightly lower in dexmedetomidine group than other two groups (VAS-1,2,3 respectively and HSL -4,6,6 respectively) with statistically significant association (P<0.001). The proportion of Bradycardia and hypertension was slightly higher(13.3%) in dexmedetomidine group than other two groups whereas patients with excessive sedation 16.7% in midazolam group. The proportion of patients requiring analgesic for the first 24 hours was 36.7% in saline group, 33.33% in midazolam group. The association between symptoms and study groups was statistically not significant (P value>0.05) except with number of patients requiring analgesic for the first 24 hours (P value<0.05).

Conclusions: Measurement of patient and anesthesiologist satisfaction scores are more or less similar in midazolam and dexmedetomidine groups compare to saline group.


Keywords


Dexmedetomidine, Midazolam, Spinal anesthesia

Full Text:

PDF

References


Ok HG, Baek SH, Baik SW, Kim HK, Shin SW, Kim KH. Optimal dose of dexmedetomidine for sedation during spinal anesthesia. Kr j Anesth. 2013;64(5):426-31.

De Andres J, Valia JC, Gil A, Bolinches R. Predictors of patient satisfaction with regional anesthesia. Reg Anesth. 1995;20(6):498-505.

Upadhyay S, Samanth U, Tellicherry S, Mallick P. Role of intravenous dexmedetomidine in prolonging postoperative analgesia and quality of block following spinal anaesthesia. A Systemic Review Update. J Pain Relief. 2015;4(175):2.

Kaya FN, Yavascaoglu B, Turker G, Yildirim A, Gurbet A, Mogol EB, et al. Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia. Can J Anaesth. 2010;57(1):39-45.

Ozaki M, Takeda J, Tanaka K, Shiokawa Y, Nishi S, Matsuda K, et al. Safety and efficacy of dexmedetomidine for long-term sedation in critically ill patients. J Anesthesia. 2014;28(1):38-50.

Jo YY, Lee D, Jung WS, Cho NR, Kwak HJ. Comparison of Intravenous Dexmedetomidine and Midazolam for Bispectral Index-Guided Sedation During Spinal Anesthesia. Medical Science Monitor : Inter Med J Exp Clin Res. 2016;22:3544-51.

Cheung CW, Ying CL, Chiu WK, Wong GT, Ng KF, Irwin MG. A comparison of dexmedetomidine and midazolam for sedation in third molar surgery. Anaesthesia. 2007;62(11):1132-8.

Demiraran Y, Korkut E, Tamer A, Yorulmaz I, Kocaman B, Sezen G, et al. The comparison of dexmedetomidine and midazolam used for sedation of patients during upper endoscopy: A prospective, randomized study. Can J Gastroenterol. 2007;21(1):25-9.

Liao W, Ma G, Su QG, Fang Y, Gu BC, Zou XM. Dexmedetomidine versus midazolam for conscious sedation in postoperative patients undergoing flexible bronchoscopy: a randomized study. J Int Med Res. 2012;40(4):1371-80.

Samantaray A, Hemanth N, Gunnampati K, Pasupuleti H, Mukkara M, Rao MH. Comparison of the effects of adding dexmedetomidine versus midazolam to intrathecal bupivacaine on postoperative analgesia. Pain physician. 2015;18(1):71-7.