A Comparative Clinical Study of Effectiveness of Two Doses of Dexmedetomidine as Adjuvant to Intrathecal Bupivacaine in Adult Patients Undergoing Lower Limbs Orthopedic Surgeries

Background: Anesthetic techniques for orthopedic surgical procedures include general and regional anesthesia techniques. Over the past decades, regional anesthesia has become the anesthetic technique of choice for many orthopedic procedures. Regional anesthesia entails the injection of local anesthetic solutions to interrupt signal transmission in peripheral nerves or spinal nerve roots that provide sensory and motor supply to operative structures. Aim and Objectives: This study aimed to improve the outcome of lower limbs orthopedic surgeries in adult patients by decreasing postoperative pain. Methods: The current randomized controlled clinical trial was conducted on 26 subjects who underwent lower limb orthopedic surgeries. They were divided into two groups: Group 1 (n=13): received 2.5 ml bupivacaine + 3 mcg dexmedetomidine. Group 2 (n=13): received 2.5 ml bupivacaine + 6 mcg dexmedetomidine.Results: The demographic data showed no significant differences between the two groups in terms of age, gender, BMI, ASA classification, and surgery duration. The group receiving 6 mcg of dexmedetomidine (Group 2) exhibited significantly lower heart rates at multiple time points compared to the 3-mcg group (Group 1). Group 2 consistently showed lower systolic, diastolic, and mean arterial pressures compared to Group 1. Group 2 demonstrated significantly lower pain scores at various time points. The higher dose group showed significantly higher sedation scores, indicating greater sedation.