Efficacy of Different Doses of Dexmedetomidine Intrathecally as an Adjuvant to Low Dose Hyperbaric Levobupivacaine in Urological Procedures: A Comparative Study to Determine the Optimal Dose

Introduction: Effective perioperative pain management in urological procedures is imperative for patient comfort and postoperative recovery. This study seeks to address this need by investigating the efficacy and safety of varying doses of intrathecal dexmedetomidine as an adjuvant to low-dose hyperbaric levobupivacaine for enhancing postoperative analgesia while maintaining hemodynamic stability. Aims & Objectives: The primary aim of this prospective, randomized, double-blind study is to determine the optimal dose of dexmedetomidine which prolongs postoperative analgesia, by comparing three varying doses. We aim to assess their respective abilities reduce the need for rescue analgesia, and minimize adverse effects in patients undergoing spinal anaesthesia for urological procedures. Methodology: 90 patients, aged 18-75y, will be randomized into three groups of 30 patients each. Each will receive hyperbaric levobupivacaine 2.2 ml with 5 µg ,7.5 µg and 10 µg of dexmedetomidine in group A, B and C respectively, diluted to 2.4 ml with 0.9 ml normal saline. After comprehensive pre-anaesthetic evaluation, standardized drug preparation, and a meticulous anaesthesia technique, continuous monitoring of vital signs, onset of sensory and motor block, and occurrence of adverse events will be noted intraoperatively. Postoperatively, the duration of analgesia, frequency of rescue analgesia, and incidence of side effects will be recorded. Significance: This study has potential to contribute to the development of tailored perioperative pain management protocols. By elucidating the most effective dose of dexmedetomidine, this research may lead to reduced opioid consumption, improved patient satisfaction, and enhanced postoperative recovery. Furthermore, the findings may offer valuable insights into optimizing pain control strategies for geriatric patients with multiple comorbidities undergoing urological surgeries under spinal anaesthesia.