Background Intrathecalanesthesia with dexmedetomidine and butorphanol as adjuvant to levbupivacaine with the advantages of delayed onset of post-operative pain and reduced analgesic requirements. The aim of this study was to evaluate the effect of intravenous dexmedetomidine and butorphanol on prolongation of intrathecal spinal anesthesia, post-operative analgesic requirement and level of sedation,
Methods The randomized, double blind comparative study was conducted in 30 patients in each groups belonging to ASA grade I, II or III, aged 20-55 years admitted for lower limbs surgeries under spinal anesthesia. All patients were administered 15mg of 0.5% levobupivacaine for spinal anesthesia. Group (L) received15 mg of 0.5% levobupivacaine with normal; Group (L+D) received 15 mg of 0.5% levobupivacaine dexmedetomidine (1μg/kg) IV; while Group (L+B) received 15 mg of 0.5% levobupivacaine with butorphanol (20μg/kg) IV. Characteristics of onset, two segment regression, time for first rescue analgesic and total dose of rescue analgesics were noted. Continuous variables were compared using ANOVA with post hoc analysis using Turkey’s test.
Results The onset of analgesia, HR, SBP, DBP and SpO2 were comparable in all the three groups. The difference in the quality of analgesia was statistically significant between group L, group L+B and group L+D (P < 0.001). VAS score was highest in the group (L) while it was almost similar in butorphanol and dexmedetomidine groups. Time for first rescue analgesic and total analgesic demand were significantly different in all the groups.
Conclusion Intravenous dexmedetomidine and butorphanol prolonged postoperative analgesia with spinal levobupivacaine provide better sensory blockade in both the groups. It also providing that sedation and additional analgesia
