Spinal Bupivacaine-Dexmedetomidine versus Bupivacaine-Fentanyl for lower Limb Amputation Surgery. Effects on Early Stump and Phantom Pain

Background: in neuroaxial anesthesia, there was many adjuvants used with the purpose of increasing anesthesia duration and reduction of postoperative analgesia. Objective: comparison between dexmedetomidine and fentanyl when added to 0.5% hyperbaric bupivacaine, for lower limb amputation on early st...

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Autores principales:	Ezzedeen Fekry, Mohammed Sharf, Yousry Kandil, Salama Harby
Formato:	article
Lenguaje:	EN
Publicado:	Al-Azhar University, Faculty of Medicine (Damietta) 2019
Materias:	dexmedetomidine hyperbaric bupivacaine fentanyl phantom pain stump pain Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/58e172844bc240d88ec555a8b86b3ef9
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spelling	oai:doaj.org-article:58e172844bc240d88ec555a8b86b3ef92021-12-02T13:52:45ZSpinal Bupivacaine-Dexmedetomidine versus Bupivacaine-Fentanyl for lower Limb Amputation Surgery. Effects on Early Stump and Phantom Pain2636-41742682-378010.21608/ijma.2019.31013https://doaj.org/article/58e172844bc240d88ec555a8b86b3ef92019-07-01T00:00:00Zhttps://ijma.journals.ekb.eg/article_31013_67c239f816d47f0660c76c7f77b69ad0.pdfhttps://doaj.org/toc/2636-4174https://doaj.org/toc/2682-3780Background: in neuroaxial anesthesia, there was many adjuvants used with the purpose of increasing anesthesia duration and reduction of postoperative analgesia. Objective: comparison between dexmedetomidine and fentanyl when added to 0.5% hyperbaric bupivacaine, for lower limb amputation on early stump and phantom pain after spinal anaesthesia. Patients and Methods: Ninety patient arranged for lower limb amputation surgery were randomly allocated into three groups (each 30 patients). Each patient received 2 ml of hyperbaric bupivacaine (0.5%) plus 0.5 ml normal saline in control group (Group B) or 5µ dexmedetomidine diluted in 0.5 ml normal saline in BD group or 25 µ fentanyl diluted in 0.5 ml normal saline in BF group. Anesthesia, analgesia, sedation, hemodynamic changes, adverse effects and post-operative pain up to one month were recorded. Results: The studied groups showed no significant differences regarding demographic characteristics and hemodynamic (heart rate and mean arterial pressure). Patients in group BD had significant increase of sensory and motor block time compared to BF B groups. Post-operatively, there was a significant decrease of pain in BD group in the first 24 hours when compared to control or BF group. The postoperative mean total consumption of analgesics during the first day was significantly decreased in BD when compared to BF and control groups. Conclusions: dexmedetomidine (5μg) represents a good alternative to fentanyl (25μg) as a spinal adjuvant to bupivacaine in surgery for the lower limb.Ezzedeen FekryMohammed SharfYousry KandilSalama HarbyAl-Azhar University, Faculty of Medicine (Damietta)articledexmedetomidinehyperbaric bupivacainefentanylphantom painstump painMedicine (General)R5-920ENInternational Journal of Medical Arts, Vol 1, Iss 1, Pp 29-36 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	dexmedetomidine hyperbaric bupivacaine fentanyl phantom pain stump pain Medicine (General) R5-920
spellingShingle	dexmedetomidine hyperbaric bupivacaine fentanyl phantom pain stump pain Medicine (General) R5-920 Ezzedeen Fekry Mohammed Sharf Yousry Kandil Salama Harby Spinal Bupivacaine-Dexmedetomidine versus Bupivacaine-Fentanyl for lower Limb Amputation Surgery. Effects on Early Stump and Phantom Pain
description	Background: in neuroaxial anesthesia, there was many adjuvants used with the purpose of increasing anesthesia duration and reduction of postoperative analgesia. Objective: comparison between dexmedetomidine and fentanyl when added to 0.5% hyperbaric bupivacaine, for lower limb amputation on early stump and phantom pain after spinal anaesthesia. Patients and Methods: Ninety patient arranged for lower limb amputation surgery were randomly allocated into three groups (each 30 patients). Each patient received 2 ml of hyperbaric bupivacaine (0.5%) plus 0.5 ml normal saline in control group (Group B) or 5µ dexmedetomidine diluted in 0.5 ml normal saline in BD group or 25 µ fentanyl diluted in 0.5 ml normal saline in BF group. Anesthesia, analgesia, sedation, hemodynamic changes, adverse effects and post-operative pain up to one month were recorded. Results: The studied groups showed no significant differences regarding demographic characteristics and hemodynamic (heart rate and mean arterial pressure). Patients in group BD had significant increase of sensory and motor block time compared to BF B groups. Post-operatively, there was a significant decrease of pain in BD group in the first 24 hours when compared to control or BF group. The postoperative mean total consumption of analgesics during the first day was significantly decreased in BD when compared to BF and control groups. Conclusions: dexmedetomidine (5μg) represents a good alternative to fentanyl (25μg) as a spinal adjuvant to bupivacaine in surgery for the lower limb.
format	article
author	Ezzedeen Fekry Mohammed Sharf Yousry Kandil Salama Harby
author_facet	Ezzedeen Fekry Mohammed Sharf Yousry Kandil Salama Harby
author_sort	Ezzedeen Fekry
title	Spinal Bupivacaine-Dexmedetomidine versus Bupivacaine-Fentanyl for lower Limb Amputation Surgery. Effects on Early Stump and Phantom Pain
title_short	Spinal Bupivacaine-Dexmedetomidine versus Bupivacaine-Fentanyl for lower Limb Amputation Surgery. Effects on Early Stump and Phantom Pain
title_full	Spinal Bupivacaine-Dexmedetomidine versus Bupivacaine-Fentanyl for lower Limb Amputation Surgery. Effects on Early Stump and Phantom Pain
title_fullStr	Spinal Bupivacaine-Dexmedetomidine versus Bupivacaine-Fentanyl for lower Limb Amputation Surgery. Effects on Early Stump and Phantom Pain
title_full_unstemmed	Spinal Bupivacaine-Dexmedetomidine versus Bupivacaine-Fentanyl for lower Limb Amputation Surgery. Effects on Early Stump and Phantom Pain
title_sort	spinal bupivacaine-dexmedetomidine versus bupivacaine-fentanyl for lower limb amputation surgery. effects on early stump and phantom pain
publisher	Al-Azhar University, Faculty of Medicine (Damietta)
publishDate	2019
url	https://doaj.org/article/58e172844bc240d88ec555a8b86b3ef9
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Spinal Bupivacaine-Dexmedetomidine versus Bupivacaine-Fentanyl for lower Limb Amputation Surgery. Effects on Early Stump and Phantom Pain

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