Dexmedetomidine and sodium bicarbonate as adjuvants to epidural lidocaine : a comparative study

Abstract EN

Context Efforts to fi nd a better adjuvant in regional anesthesia have been underway since long.

Dexmedetomidine and sodium bicarbonate have been proven to be effective in providing the same pharmacological benefi t through two different mechanisms of action.

In this study, we sought to investigate which is superior between the two.

Aims The aim of the study was to compare the effi cacy of dexmedetomidine and sodium bicarbonate as adjuvants to lidocaine in epidural anesthesia.

Settings and design This was a prospective, randomized, double-blind study.

Materials and methods Sixty patients scheduled for lower-limb trauma orthopedic surgeries under epidural anesthesia were divided into two groups group D and group S, with 30 patients in each.

Patients in group D received 12.5 ml of 2% lidocaine+dexmedetomidine 0.5 μg/kg in 1.5 ml solution, making a total volume of 14 ml.

Patients in group S received 12.5 ml of 2% lidocaine+1.5 ml of 7.5% sodium bicarbonate, making a total volume of 14 ml.

Onset, time for peak sensory level, time for two-segment regression, and the total mephentermine consumed to maintain the hemodynamics were recorded, tabulated, and statistically analyzed.

Results The onset of sensory block was quicker in group D.

The time for attaining peak sensory level and the mephentermine consumption was nearly the same in both groups.

The time for two-segment regression was more in group D than in group S.

Conclusion Dexmedetomidine is more effective than sodium bicarbonate in hastening the onset and prolonging the duration of blockade when used as an adjuvant to epidural lidocaine.