Journal de la douleur et du soulagement

Abstrait

Role of Intravenous Dexmedetomidine in Prolonging Postoperative Analgesia and Quality of Block Following Spinal Anaesthesia. A Systemic Review and Update

Surjya Prasad Upadhyay*, Ulka Samanth, Sudhakar Tellicherry and Piyush Mallick

Intravenous dexmedetomidine is been increasingly used in perioperative setting including as an adjunct to local anaesthetic in various regional techniques with an intent either to improve the block quality, to increase the duration of block or to provide sedation and patient comfort during the periblock period. Intravenous dexmedetomidine when used just before or after spinal anaesthesia has many desirable effects such as adequate sedation and patient comfort, longer sensory-motor blockade, prolong postoperative analgesia and reduces post-anaesthesia shivering. A systemic review was done to evaluate and provide update on the use of intravenous dexmedetomidine as an adjunct for spinal anaesthesia. The optimal dose or method of administration of intravenous dexmedetomidine under spinal anaesthesia has not been defined yet. Current literatures suggest a ceiling effect on prolonging post-spinal analgesia after 0.5 mcg/kg boluses. With increasing the dose beyond 0.5 mcg/kg resulted in unwanted side effects notably bradycardia and excessive sedation. Further study with diverse population is needed to define the optimal dose of intravenous dexmedetomidine.