Exploring the Effect of Administering Three Different Doses of Dexmedetomidine as an Adjuvant to Lidocaine in Regional Intravenous Anesthesia for Patients
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Abstract
Background: This study aimed to determine the effect of adding low doses of dexmedetomidine as an adjuvant to lidocaine in regional intravenous anesthesia in patients receiving surgery.
Methods: In the present clinical trial, 120 patients' candidates for upper extremity orthopedic surgery with regional venous anesthesia in 4 groups of 30 people distributed in groups respectively 0.6, 0.5 and 0.4 micrograms/kg of dexmedetomidine plus 0.5 lidocaine were injected and in the fourth group, an equal volume of normal saline was administrated. Patients were examined and compared before drug injection and 1, 5, 10, 15, 30, 45 and 60 minutes after drug injection in terms of time of onset and recovery of sensory and motor block, hemodynamic parameters, postoperative pain intensity and analgesic consumption.
Results: The average pain intensity during the research in the four dexmedetomidine groups was 0.6, 0.5, 0.4 and the control group, respectively, 2.12 ± 1.33, 2.82 ± 0.76, 2.26 ± 2.3, and 4.4 ± 1.5, and the difference between the groups was significant (>0.001). P). In the two-by-two analysis of the groups, the average pain intensity was significant between the two groups: dexmedetomidine 0.6 and control (P<0.001), dexmedetomidine 0.5 and control (P=0.003), and dexmedetomidine 0.4 and control (P<0.001).
Conclusion: Using a dose of 0.6 micrograms/kg of dexmethomidine along with lidocaine leads to a decrease in the severity of the postoperative period, a decrease in the need for painkillers, and also an increase in the time of postoperative pain relief in patients.
[2] Egan TD. Miller's anesthesia. Anesthesiology. 2005;103(3):673-4.
[3] Sørensen A, Dalsgaard J, Hansen TB. Local anaesthesia versus intravenous regional anaesthesia in endoscopic carpal tunnel release: a randomized controlled trial. J Hand Surg Eur Vol. 2013;38(5):481-4.
[4] Nasirinezhad F, Hosseini M, Karami Z, Yousefifard M, Janzadeh A. Spinal 5-HT3 receptor mediates nociceptive effect on central neuropathic pain; possible therapeutic role for tropisetron. J Spinal Cord Med. 2016;39(2):212-9.
[5] Chiao F, Chen J, Lesser J, Resta-Flarer F, Bennett H. Single-cuff forearm tourniquet in intravenous regional anaesthesia results in less pain and fewer sedation requirements than upper arm tourniquet. Br J Anaesth. 2013;111(2):271-5.
[6] Nazemroaya B, Jabalameli M, Kamali A. Assessing the Effects of Dexmedetomidine and Labetalol on Changes in Heart Rate and Blood Pressure after Laryngoscopy Compared to a Control Group. J Cell Mol Anesth. 2020;5(2):79-83.
[7] Golparvar M, Borooojeni AAM. A Comparative Study of the Effect of Adding Dexmedetomidine, Dexamethasone and Sodium Bicarbonate to Ropivacaine in Ultrasound Guided Supraclavicular Block on the Quality of the Block in Orthopedic Surgery. Arch Anesth Crit Care. 2024;10(Suppl 2):571-7.
[8] Safavi M, Honarmand A, Nazemroaya B, Maleky N. Comparative Study of the Preemptive Dexmedetomidine Versus Ondansetron Effect in Post-Operative Nausea and Vomiting after Middle Ear Surgery. Arch Anesth & Crit Care. 2023;10(3):221-226.
[9] Nazemroaya B, Honarmand A, Ashar MBH. Effects of adding dexmedetomidine to ketamine on heart rate and blood pressure changes in psychiatric patients undergoing electroconvulsive therapy. Koomesh. 2020;22(2):311-6.
[10] Arrow P. A comparison of articaine 4% and lignocaine 2% in block and infiltration analgesia in children. Aust Dent J. 2012;57(3):325-33.
[11] Sridhar P, Sistla SC, Ali SM, Karthikeyan VS, Badhe AS, Ananthanarayanan PH. Effect of intravenous lignocaine on perioperative stress response and post-surgical ileus in elective open abdominal surgeries: a double-blind randomized controlled trial. ANZ J Surg. 2015;85(6):425-9.
[12] Marhofer D, Kettner S, Marhofer P, Pils S, Weber M, Zeitlinger M. Dexmedetomidine as an adjuvant to ropivacaine prolongs peripheral nerve block: a volunteer study. Br J Anaesth. 2012;110(3):438-42.
[13] Djaiani G, Silverton N, Fedorko L, Carroll J, Styra R, Rao V, et al. Dexmedetomidine versus propofol sedation reduces delirium after cardiac surgery: a randomized controlled trial. Anesthesiology. 2016;124(2):362-8.
[14] Cai Y, Xu H, Yan J, Zhang L, Lu Y. Molecular targets and mechanism of action of dexmedetomidine in treatment of ischemia/reperfusion injury. Mol Med Rep. 2014;9(5):1542-50.
[15] NilEkANi E, MENEzES Y, D'souza SA. A Study on the Efficacy of the Addition of Low Dose Dexmedetomidine as an Adjuvant to Lignocaine in Intravenous Regional Anaesthesia (IVRA). J Clin Diagn Res. 2016;10(10):UC01-4.
[16] Fritsch G, Danninger T, Allerberger K, Tsodikov A, Felder TK, Kapeller M, et al. Dexmedetomidine added to ropivacaine extends the duration of interscalene brachial plexus blocks for elective shoulder surgery when compared with ropivacaine alone: a single-center, prospective, triple-blind, randomized controlled trial. Reg Anesth Pain Med. 2014;39(1):37-47.
[17] Jarineshin H, Baghaei AA, Fekrat F, Kargar A, Abdi N, Navabipour S, et al. Comparison of two different doses of dexmedetomidine in attenuating cardiovascular responses during laryngoscopy and endotracheal intubation: A double blind, randomized, clinical trial study. J Med Life. 2015;8(Spec Iss 4):45-50.
[18] Farooq N, Singh RB, Sarkar A, Rasheed MA, Choubey S. To evaluate the efficacy of fentanyl and dexmedetomidine as adjuvant to ropivacaine in brachial plexus block: a double-blind, prospective, randomized study. Anesth Essays Res. 2017;11(3):730-5.
[19] Gupta B, Verma RK, Kumar S, Chaudhary G. Comparison of analgesic efficacy of dexmedetomidine and midazolam as adjuncts to lignocaine for intravenous regional anesthesia. Anesth Essays Res. 2017;11(1):62-7.
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