The aim of this study was to assess the effect of intrathecally injected 5 µg dexmedetomidine or 25 µg fentanyl as adjuvants to bupivacaine in low dose spinal anesthesia for unilateral arthroscopic knee surgeries, on post-operative urinary retention (POUR), time needed to reach sensory block at the tenth thoracic dermatome (T10), the maximum sensory level achieved, the onset of motor block, the intra-operative fluids given, the duration of sensory and motor blocks, time to micturition or insertion of an intermittent urinary catheter and the number of patients who needed an indwelling (Foley's) catheter. Seventy patients, ASA physical status I or II, from 21 to 50 years old, scheduled to undergo unilateral arthroscopic knee surgeries under spinal anesthesia, were randomly divided into two equal groups; the Bupivacaine- Dexmedetomidine group (BD) patients and the Bupivacaine-Fentanyl group (BF) patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
TRIPLE
Enrollment
70
In a 3 ml syringe, 5 µg dexmedetomidine was added to the 2 ml of 10 mg hyperbaric bupivacaine, to have a total volume of 2.5 ml for intrathecal spinal injection over 3 minute without barbotage
In a 3 ml syringe, 25 μg fentanyl was added to the 2 ml of 10 mg hyperbaric bupivacaine, to have a total volume of 2.5 ml for intrathecal spinal injection over 3 minute without barbotage
Faculty of Medicine
Cairo, Egypt
Post-operative urinary retention
Ultrasound assessment of the urinary bladder volume was done at the 3rd post-operative hour, a bladder volume of \>700 ml with no ability to void confirmed the presence of urinary retention
Time frame: 3 hours
Time to reach sensory block at T10
The time from completion of intrathecal injection of the study drug till loss of sensation to pin prick at T10 on the operative side, assessed every 2 minutes.
Time frame: 30 minutes
Maximum sensory level achieved
Sensory level assessment by loss of sensation to pinprick every 2 minutes, until the highest level had stabilized for four consecutive tests
Time frame: 30 minutes
The onset of motor block
The time from completion of intrathecal injection of the study drug till having a modified Bromage score = 1 or more
Time frame: 30 minutes
Intra-operative fluids given
The volume of IV Ringer's solution given to each patient according to the fluid chart
Time frame: 3 hours
Duration of sensory block
he time from completion of intrathecal injection of the study drug till regression to the third sacral dermatome (S3) level
Time frame: 6 hours
Duration of motor block
The time from completion of intrathecal injection of the study drug till complete recovery of the motor function (MBS = 0), by asking the patient to flex the hip, knee and ankle joints, in the PACU, then every 15 minutes in the ward
Time frame: 6 hours
Time to micturition or insertion of an intermittent urinary catheter
The time from completion of intrathecal injection of the study drug till voiding or insertion of an in-out catheter
Time frame: 6 hours
Number of patients who needed an indwelling (Foley's) catheter
After 6 post-operative hours, if the patient wasn't able to void an indwelling (Foley's) catheter was then placed
Time frame: 6 hours
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