To evaluate the efficacy of addition of dexmedetomidine to bupivacaine versus bupivacaine administered as a nerve block for post operative analgesia in patients undergoing lefort I osteotomy
Background and objective:The effect of dexmedetomidine on the duration of sensory blockade has not been studied in humans. We evaluated the effect of adding dexmedetomidine to bupivacaine on the duration of postoperative analgesia in children who underwent Lefort I osteotomy.
Methods:Ten patients who were scheduled for Lefort I osteotomy using a combination of general anaesthesia and greater palatine nerve block were allocated randomly into one of two equal groups. In both groups, two infraorbital and two posterior superior alveolar nerves was performed bilaterally using 2 ml of solution on each side. The Bupivacaine-dexmedtomidine group received bupivacaine 0.25%,with 1mg/kg dexmedetomidine whereas the Bupivacaine group received bupivacaine 0.25%. Heart rate, systolic blood pressure, pain score, the time to the first request for analgesia, and the degree of sedation were recorded Results :There was no difference in haemodynamic variables between the two groups. The pain score was significantly higher in the B group as compared with the Bupivacaine-Dexmedetomidine group. The time to the first request for analgesia was significantly longer in patients in the Bupivacaine-Dexmedetomidine group (mean 22 h, range 20.6 – 23.7 h) as compared with those who received bupivacaine alone (14.2 h, 13 – 15 h). Sedation scores in the postoperative period did not differ between the study groups.
Conclusion Nerve block with a combination of dexmedetomidine and bupivacaine increased the duration of analgesia after Lefort I osteotomy by 50% with no clinically relevant side effects.
Keywords:Dexmedetomidine, Bupivacaine, Lefort I osteotomy, Regional anaesthesia
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