evaluation of the effect of transdermal nitroglycerine patch on intrathecal dexmedetomidine as additive, on postoperative analgesia after abdominal hysterectomy

evaluation of the effect of transdermal nitroglycerine patch on intrathecal dexmedetomidine as additive, on postoperative analgesia after abdominal hysterectomy

;Rama Chatterji;Anupama Gupta;Vinay Kumar Sharma;Chandra Shekhar Chatterji
Minerva anestesiologica 2017 Vol. 18 pp. 51-55
385
chatterji2017theevaluation

Abstract

Aim: The aim of this study is to evaluate the effect of transdermal nitroglycerin on intrathecal dexmedetomidine as additive, on postoperative analgesia after abdominal hysterectomy. Materials and Methods: Totally 140 patients of the American Society of Anesthesiologists Grade I or II, posted for abdominal hysterectomy under spinal anesthesia, were randomized to four groups using computer-generated random number list. Group B received 3 ml of 0.5% hyperbaric bupivacaine with 0.5 ml normal saline and placebo patch, Group BN received 3 ml of 0.5% hyperbaric bupivacaine with 0.5 ml NS and transdermal nitroglycerin (t-NTG), Group BD received 3 ml of 0.5% hyperbaric bupivacaine with 5 mcg (0.5 ml) dexmedetomidine and placebo patch and Group BDN received 3 ml of 0.5% hyperbaric bupivacaine with 5 μg (0.5 ml) dexmedetomidine and t-NTG patch. Outcomes measured include the total duration of analgesia, onset, and duration of sensory and motor block and any adverse effects. Results: The total duration of analgesia was longest in Group BDN (349.9 ± 40.6 min). It was significantly longer than Group BD (252.3 ± 34.0 min) and Group B and BN (130.5 ± 18.8, 138.3 ± 19.2 min). Time taken for two segment regression was comparable in Group B (79.9 ± 14.4 min) and Group BN (87.1 ± 22.6 min), but it was significantly longer in Group BD (122.5 ± 17.2 min) and Group BDN (136.4 ± 25.5 min). There was no significant difference in other variables between the groups. Conclusion: Transdermal nitroglycerine itself does not exhibit any analgesic potential of its own but, it enhances the analgesic potential of intrathecal dexmedetomidine.

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