Journal of Anesthesia

, Volume 24, Issue 4, pp 544–548 | Cite as

The effects of intravenous dexmedetomidine on spinal hyperbaric ropivacaine anesthesia

  • Kamuran Elcıcek
  • Murat TekınEmail author
  • Ismail Katı
Original Article



In this study we investigated the effects of intravenously administered dexmedetomidine on the duration of hyperbaric ropivacaine in spinal anesthesia, and the side effects.


In a prospective, double-blind study, sixty ASA I-II patients were randomized to two groups of 30 individuals. All patients were administered hyperbaric ropivacaine (22.5 mg) for spinal anesthesia. Intravenous dexmedetomidine was administered in group I for 60 min, physiological saline at the same amount and duration was infused in group II.


Measurements of mean blood pressure before and after the procedure revealed significant decreases in group I compared with group II after 20, 25, and 30 min. The times for two dermatomes regression of the blockade and complete resolution of motor blockade were significantly prolonged in group I. The sedation score in the dexmedetomidine group was significantly increased compared with controls. Atropine requirement was found to be significantly higher in group I than in group II.


Our results show that intravenously administered dexmedetomidine prolonged the duration of spinal anesthesia, provided sufficient sedation, and had few side effects. Therefore, dexmedetomidine is appropriate during spinal anesthesia, if the anesthesiologist is alert for development of bradycardia.


Dexmedetomidine Hyperbaric ropivacaine Spinal anesthesia 



We would like to thank Dr. I. Coskuner and Dr. C. Yagmur for their assistance.


  1. 1.
    Brown DL. Spinal, epidural and caudal anesthesia. In: Miller RD, editor. Anesthesia. Philadelphia: Churchill-Livingstone; 2000. p. 1492–8.Google Scholar
  2. 2.
    Bernard CM. Epidural and spinal anesthesia. In: Barash PG, editor. Clinical anesthesia. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 645–68.Google Scholar
  3. 3.
    Rhee K, Kang K, Kim J, Jeon Y. Intravenous clonidine prolongs bupivacaine spinal anesthesia. Acta Anaesthesiol Scand. 2003;47:1001–5.CrossRefPubMedGoogle Scholar
  4. 4.
    Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R, Bulbul M, Baraka AS. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Acta Anaesthesiol Scand. 2006;50:222–7.CrossRefPubMedGoogle Scholar
  5. 5.
    Whiteside JB, Burke D, Wildsmith JAW. Spinal anaesthesia with ropivacaine 5 mg/ml in glucose 10 mg/ml or 50 mg/ml. Br J Anaesth. 2001;86:241–4.CrossRefPubMedGoogle Scholar
  6. 6.
    Whiteside JB, Burke D, Wildsmith JAW. Comparison of ropivacaine 0.5% (in glucose 5%) with bupivacaine 0.5% (in glucose 8%) for spinal anaesthesia for elective surgery. Br J Anaesth. 2003;90:304–8.CrossRefPubMedGoogle Scholar
  7. 7.
    McLeod GA. Density of spinal anaesthetic solutions of bupivacaine, levobupivacaine, and ropivacaine with and without dextrose. Br J Anaesth. 2004;92:547–51.CrossRefPubMedGoogle Scholar
  8. 8.
    Chung CJ, Choi SR, Yeo KH, Park HS, Lee SI, Chin YJ. Hyperbaric spinal ropivacaine for cesarean delivery: a comparison to hyperbaric bupivacaine. Anesth Analg. 2001;93:157–61.CrossRefPubMedGoogle Scholar
  9. 9.
    Dawson C, Ma D, Chow A, Maze M. Dexmedetomidine enhances analgesic action of nitrous oxide: mechanisms of action. Anesthesiology. 2004;100:894–904.CrossRefPubMedGoogle Scholar
  10. 10.
    Gentili M, Huu PC, Enel D, Hollande J, Bonnet F. Sedation depends on the level of sensory block induced by spinal anaesthesia. Br J Anaesth. 1998;81:970–1.PubMedGoogle Scholar
  11. 11.
    Pollock JE, Neal JM, Liu SS, Burkhead D, Polissar N. Sedation during spinal anesthesia. Anesthesiology. 2000;93:728–34.CrossRefPubMedGoogle Scholar
  12. 12.
    Pouttu J, Scheinin B, Rosenberg PH, Viinamaki O, Scheinin M. Oral premedication with clonidine: effects on stress responses during general anaesthesia. Acta Anaesthesiol Scand. 1987;31:730–4.CrossRefPubMedGoogle Scholar
  13. 13.
    Almeida RA, Lauretti GR, Mattos AL. Antinociceptive effect of low-dose intrathecal neostigmine combined with intrathecal morphine following gynecologic surgery. Anesthesiology. 2003;98:495–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Maze M, Tranquilli W. Alpha-2 adrenoceptor agonists: defining the role in clinical anesthesia. Anesthesiology. 1991;74:581–605.CrossRefPubMedGoogle Scholar
  15. 15.
    Mikawa K, Nishina K, Maekawa N, Obara H. Oral clonidine premedication reduces postoperative pain in children. Anesth Analg. 1996;82:225–30.CrossRefPubMedGoogle Scholar
  16. 16.
    Weinbroum AA, Ben-Abraham R. Dextromethorphan and dexmedetomidine: new agents for the control of perioperative pain. Eur J Surg. 2001;167:563–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Choyce A, Peng P. A systematic review of adjuncts for intravenous regional anesthesia for surgical procedures. Can J Anaesth. 2002;49:32–45.CrossRefPubMedGoogle Scholar
  18. 18.
    Memis D, Turan A, Karamanlioglu B, Pamukçu Z, Kurt I. Adding dexmedetomidine to lidocaine for intravenous regional anesthesia. Anesth Analg. 2004;98:835–40.PubMedGoogle Scholar
  19. 19.
    Jaakola ML. Dexmedetomidine premedication before intravenous regional anesthesia in minor outpatient hand surgery. J Clin Anesth. 1994;6:204–11.CrossRefPubMedGoogle Scholar
  20. 20.
    Lurie SD, Reuben SS, Gibson CS, DeLuca PA, Maciolek HA. Effect of clonidine on upper extremity tourniquet pain in healthy volunteers. Reg Anesth Pain Med. 2000;25:502–5.PubMedGoogle Scholar
  21. 21.
    Kristensen JD, Karlsten R, Gordh T. Spinal cord blood flow after intrathecal injection of ropivacaine: a screening for neurotoxic effects. Anesth Analg. 1996;82:636–40.CrossRefPubMedGoogle Scholar
  22. 22.
    Kallio A, Scheinin M, Koulu M, Ponkilainen R, Ruskoaho H, Viinamäki O, Scheinin H. Effects of dexmedetomidine, a selective α-2-adrenoceptor agonist, on hemodynamic control mechanisms. Clin Pharmacol Ther. 1989;46:33–42.PubMedGoogle Scholar
  23. 23.
    Bloor BC, Ward DS, Belleville JP, Maze M. Effects of intravenous dexmedetomidine in humans. II. Hemodynamic changes. Anesthesiology. 1992;77:1134–42.CrossRefPubMedGoogle Scholar
  24. 24.
    Mantz J. Dexmedetomidine. Drugs Today (Barc). 1999;35:151–7.Google Scholar
  25. 25.
    Carpenter RL, Caplan RA, Brown DL, Stephenson C, Wu R. Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology. 1992;76:906–16.CrossRefPubMedGoogle Scholar
  26. 26.
    Katı İ, Demirel CB, Abbasov ÜH, Silay E, Coşkuner İ, Tomak Y. İğne Tipinin Spinal Anestezi Komplikasyonları Üzerine Etkileri. Van Tıp Dergisi. 2002;9:20–4.Google Scholar
  27. 27.
    Tarkkila PJ, Heine H, Tervo RR. Comparison of Sprotte and Quincke needles with respect to post dural puncture headache and backache. Reg Anesth. 1992;17:283–7.PubMedGoogle Scholar
  28. 28.
    Vassilieff N, Rosencher N, Sessler DI, Conseiller C. Shivering threshold during spinal anesthesia is reduced in elderly patients. Anesthesiology. 1995;83:1162–6.CrossRefPubMedGoogle Scholar
  29. 29.
    Sessler DI. Perianesthetic thermoregulation and heat balance in humans. FASEB J. 1993;7:638–44.PubMedGoogle Scholar

Copyright information

© Japanese Society of Anesthesiologists 2010

Authors and Affiliations

  1. 1.Anesteziyoloji ve Reanimasyon ADKocaeli Universitesi Tıp FakültesiKocaeliTurkey
  2. 2.Department of AnesthesiologyYuzuncu Yil UniversityVanTurkey

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