Effect of hyperbaric ropivacaine with and without dexmedetomidine as an adjuvant in spinal anaesthesia for caesarean section:A prospective observational study

Spinal anaesthesia is technique of choice for anaesthesia in patients undergoing caesarean section due to its rapid onset, surety of effect, decreased blood loss and good safety profile. With the advantage of avoiding maternal risk of general anaesthesia including failure of tracheal intubation, aspiration pneumonitis and lung infection.

Ropivacaine, a long acting amino-amide local anaesthetic agent is similar to bupivacaine in chemical structure. Previous studies for isobaric ropivacaine for neuraxial blockage have been shown to be safe and effective [1]. Hyperbaric local anaesthetics produce predictable block characteristics and effective spinal anaesthesia.

Dexmedetomidine, a highly selective alpha-2 adrenergic agonist provides sedative, analgesic, anti-sympathetic effects and has no significant effect on respiration. The results of previous study indicate that 5 microgram dexmedetomidine as an intrathecal adjuvant to 0.5% hyperbaric bupivacaine for caesarean section is useful as it hastens the onset of sensory and motor block and prolongs postoperative analgesia and motor blockage without producing significant hemodynamic changes, sedation and neonatal adverse effects [2].

As this technique and drugs being used routinely in our institute, we are just doing observation of what is happening. We are not doing any intervention in standard protocol of our institute. So this is a observational study.

So, we aim to study the recently available hyperbaric ropivacaine and compare it with combination of hyperbaric ropivacaine and dexmedetomidine 5 microgram given intrathecally for lower segment caesarean section.