Anesthetic and analgesic efficacy, hemodynamic changes, and sedation following addition of dexmedetomidine to lignocaine in intravenous regional anesthesia for minor hand surgery

Abstract EN

Background and aims Adding dexmedetomidine to local anesthetics in intravenous regional anesthesia has been found to produce effective anesthesia and analgesia for minor hand surgery.

The aim of this study was to compare hemodynamic changes, adverse effects, patient satisfaction, and anesthetic, analgesic, and sedation qualities in patients who received lidocaine only versus those who received dexmedetomidine with lidocaine during minor hand surgery.

Methods One hundred patients scheduled for minor hand surgery were randomly allocated into two equal groups: group L and group DL.

Patients in group L received 3 mg/kg lidocaine 0.5% (maximum dose 200 mg), and patients in group DL received 3 mg/kg lidocaine 0.5% (maximum dose 200 mg) + 0.5 μg/kg dexmedetomidine; the total volume was diluted to 40 ml with normal saline 0.9% in both groups and injected at a rate of 20 ml/min.

Anesthesia, analgesia, and sedation qualities, hemodynamic changes, patient satisfaction, and adverse effects were recorded.

Results The studied groups showed no signifi cant difference in demographic data.

In hemodynamics, mean arterial blood pressure and heart rate showed a statistically signifi cant difference during and up to 30 min after tourniquet release (P < 0.001), and oxygen saturation showed no statistically signifi cant difference during and after surgery (P > 0.05).

There were statistically signifi cant differences between the two groups (P < 0.05) as regards the quality of anesthesia, time of regression of sensory and motor blocks, and patient satisfaction.

There were more patients who reported excellent satisfaction in the DL group (76%) compared with the L group (20%).

Intraoperative and postoperative analgesic requirements were greater in the lidocaine group than in the dexmedetomidine group, and postoperative pain score (visual analog scale) was lower in the DL group compared with L group.

Sedation score after release of tourniquet was signifi cantly higher in the DL group compared with the L group except in the fi rst 5 min.

Conclusion On the basis of the results in this study we concluded that dexmedetomidine is a good adjuvant anesthetic, analgesic, and sedative agent in intravenous regional anesthesia.