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Comparison of fentanyl and dexmedetomidine as an adjuvant to bupivacaine for unilateral spinal anesthesia in lower limb surgery: a randomized trial / Comparação de fentanil e dexmedetomidina como adjuvante à bupivacaína para raquianestesia unilateral em cirurgia de membros inferiores: estudo randômico
Taher-Baneh, Naseh; Ghadamie, Negin; Sarshivi, Farzad; Sahraie, Reza; Nasseri, Karim.
  • Taher-Baneh, Naseh; Kurdistan University of Medical Sciences. School of Medicine. Department of Anesthesiology. Sanandaj. IR
  • Ghadamie, Negin; Kurdistan University of Medical Sciences. Faculty of Medicine. Department of Anesthesiology. Sanandaj. IR
  • Sarshivi, Farzad; Kurdistan University of Medical Sciences. Faculty of Medicine. Department of Anesthesiology. Sanandaj. IR
  • Sahraie, Reza; Kurdistan University of Medical Sciences. Faculty of Medicine. Department of Orthopedic Surgery. Sanandaj. IR
  • Nasseri, Karim; Kurdistan University of Medical Sciences. Faculty of Medicine. Department of Anesthesiology. Sanandaj. IR
Rev. bras. anestesiol ; 69(4): 369-376, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1042003
ABSTRACT
Abstract Background and objectives One of the disadvantages of unilateral spinal anesthesia is the short duration of post-operative analgesia, which can be addressed by adding adjuvants to local anesthetics. The aim of current study was to compare the effects of adding dexmedetomidine, fentanyl, or saline to bupivacaine on the properties of unilateral spinal anesthesia in patients undergoing calf surgery. Methods In this double-blind clinical trial, 90 patients who underwent elective calf surgery were randomly divided into three groups. The spinal anesthetic rate in each of the three groups was 1 mL bupivacaine 0.5% (5 mg). In groups BD, BF and BS, 5 µg of dexmedetomidine, 25 µg of fentanyl and 0.5 mL saline were added, respectively. The duration of the motor and sensory blocks in both limbs and the rate of pain during 24 h after surgery were calculated. Hemodynamic changes were also measured during anesthesia for up to 90 min. Results The duration of both of motor and sensory block was significantly longer in dependent limb in the BF (96 and 169 min) and BD (92 and 166 min) groups than the BS (84 and 157 min) group. Visual Analog Scale was significantly lower in the two groups of BF (1.4) and BD (1.3), within 24 h after surgery, than the BS (1.6) group. Conclusions The addition of fentanyl and dexmedetomidine to bupivacaine in unilateral spinal anesthesia can increase the duration of the motor and sensory block in dependent limb and prolong the duration of postoperative pain. However, fentanyl is more effective than dexmedetomidine.
RESUMO
Resumo Justificativa e objetivos Uma das desvantagens da raquianestesia unilateral é a curta duração da analgesia pós-operatória, que pode ser abordada pela adição de adjuvantes aos anestésicos locais. O objetivo deste estudo foi comparar os efeitos da adição de dexmedetomidina, fentanil ou solução salina à bupivacaína sobre as propriedades da raquianestesia unilateral em pacientes submetidos à cirurgia de panturrilha. Métodos Neste ensaio clínico duplo-cego, 90 pacientes submetidos à cirurgia eletiva de panturrilha foram randomicamente divididos em três grupos. A quantidade de anestésico para a raquianestesia nos três grupos foi de 1 mL de bupivacaína a 0,5% (5 mg). Nos grupos BD, BF e BS, 5 µg de dexmedetomidina, 25 µg de fentanil e 0,5 mL de solução salina foram adicionados, respectivamente. Foram calculados a duração dos bloqueios motor e sensorial em ambos os membros e o escore de dor durante 24 horas após a cirurgia. As alterações hemodinâmicas também foram medidas durante a anestesia por até 90 minutos. Resultados A duração de ambos os bloqueios, motor e sensorial, foi significativamente maior no membro dependente nos grupos BF (96 e 169 min) e BD (92 e 166 min) do que no grupo BS (84 e 157 min). Os escores da escala visual analógica foram significativamente menores nos grupos BF (1,4) e BD (1,3) do que no grupo BS (1,6) nas 24 horas após a cirurgia. Conclusões A adição de fentanil e dexmedetomidina à bupivacaína em raquianestesia unilateral pode aumentar a duração dos bloqueios sensorial e motor no membro dependente e prolongar a duração da dor pós-operatória. Contudo, fentanil é mais eficaz do que dexmedetomidina.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Bupivacaine / Fentanyl / Dexmedetomidine / Anesthesia, Spinal Type of study: Controlled clinical trial Limits: Adult / Female / Humans / Male Language: English Journal: Rev. bras. anestesiol Journal subject: Anesthesiology Year: 2019 Type: Article Affiliation country: Iran Institution/Affiliation country: Kurdistan University of Medical Sciences/IR

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Full text: Available Index: LILACS (Americas) Main subject: Bupivacaine / Fentanyl / Dexmedetomidine / Anesthesia, Spinal Type of study: Controlled clinical trial Limits: Adult / Female / Humans / Male Language: English Journal: Rev. bras. anestesiol Journal subject: Anesthesiology Year: 2019 Type: Article Affiliation country: Iran Institution/Affiliation country: Kurdistan University of Medical Sciences/IR