Document resource
Background and Aims Dexmedetomidine is a selective alpha-2 adrenergic agonist widely used for conscious sedation. It inhibits the release of excitatory neurotransmitters and has a synergistic effect with local anesthetics. Prolongs the duration of both sensory and motor block in a dose-dependent manner and delays the need for postoperative analgesia without increasing adverse effects. Younger patients require higher doses of bupivacaine and experience shorter durations of sensory and motor block compared to elderly patients. Adjuvants allow to reduce local anesthetic doses. Also, dexmedetomidine provides anxiolysis, improving patient satisfaction.Methods Eight cases reports, ASA I-II patients, described at table 1 (Image 1). Surgeries lasted approximately 150 minutes and were completed without changing the anesthetic plan or administrating rescue analgesics. Postoperative analgesia consisted of scheduled NSAIDs every 8 hours. Motor block duration was measured using the time taken to reach a Bromage scale score of II. Sensory block was assessed through examiner palpation. Pain was evaluated using the visual analog scale (VAS) at one hour and 24 hours post-procedure. Sedation was monitored with the MOAA/S scale at 30-minute intervals. Adverse events such as oxygen saturation < 92%, mean arterial pressure <65 mmHg, and bradycardia <50 bpm were also recorded. We used 2 ml ampoules of Dexmedetomidine 100 mcg/ml. The content is sterile and contains water for injectable preparations and sodium chloride as excipients. Each ml contains less than 1 mmol (3.5 mg) of sodium, having that concentration and volume no potential for neurotoxicity.Results Described at table 2 (image 1).Conclusions - Intrathecal dexmedetomidine as an adjuvant is a safe strategy to prolong sensory block in spinal anesthesia without increasing the dose of local anesthetic and without excessively prolonging motor block. - Intrathecal dexmedetomidine has an anxiolytic effect that improves intraoperative analgesic quality in young patients. - 10 mcg dose is safe to achieve benefits without increasing adverse effects.Abstract EP041 Figure 1Description of cases and results