RESEARCH ARTICLE


Low-dose Bupivacaine with Dexmedetomidine Prevents Hypotension After Spinal Anesthesia



Young Seop Chang1, Ji-Eun Kim2, Tae-Yun Sung2, *
1 Department of Urology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea;
2 Department of Anaesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea


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Creative Commons License
© 2015 Chang et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the 158, Gwangeodong-ro, Seogu, Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, 302-718, Korea; Tel: +82-42-600-9316; Fax: +82-42-545-2132; E-mail: unt1231@naver.com


Abstract

Background:

We assessed whether intrathecal low-dose bupivacaine with dexmedetomidine could reduce the incidence of spinal anesthesia (SA)-related hypotension.

Methods:

In total, 47 patients undergoing urological or orthopedic surgery under SA were randomized into two groups. SA was induced using 12.5 mg of hyperbaric bupivacaine alone (Group B; n = 24 patients) or 6 mg of hyperbaric bupivacaine plus 4 μg of dexmedetomidine and 0.3 ml of saline (Group BD; n = 23 patients). At 10 min after SA, dexmedetomidine was infused in both groups at a loading dose of 0.5 µg/kg, administered over 10 min, and then maintained at a dose of 0.2 µg/kg/h for 40 min.

Results:

The incidence of hypotension was significantly higher in Group B than in Group BD (50.0 vs. 17.4%, P = 0.018). The amount of ephedrine used to treat hypotension was significantly higher in Group B than in Group BD (median [range], 3 [0–30] vs. 0 [0–12] mg, P = 0.014).

Conclusion:

Low-dose bupivacaine plus dexmedetomidine SA reduced the incidence of hypotension compared to conventional bupivacaine SA.

Keywords: Bupivacaine, dexmedetomidine, hypotension, spinal anesthesia.