Dexmedetomidine prolongs spinal anaesthesia induced by levobupivacaine 0.5% in guinea-pigs

Abstract

Alpha-2 adrenoceptor agonists have been used in association with local anaesthetic to increase the duration of spinal anaesthesia. Intrathecal administration of clonidine prolonged motor blockade induced by local anaesthetic. Since the affinity of dexmedetomidine (DEX) to alpha-2 adrenoceptors is eight-times greater than clonidine, it is expected that DEX could be advantageous in clinical anaesthesia. We investigated the duration of motor nerve block induced by spinal injection of 0.5% levobupivacaine (LVB) associated with intrathecal or intraperitoneal administration of DEX. Seventy-two guinea-pigs were randomly divided in 12 groups, which were all treated with intrathecal injection of 50 μL of LVB. DEX was injected intrathecally with LVB in 6 groups or injected intraperitoneally after LVB in another 6 groups. Intrathecal DEX (0.1, 0.2 and 0.4 μg) increased the LVB-induced motor anaesthesia from 48 (41–66) min to 84.5 (52–91) min (P<0.05), 101.5 (83–115) min (P<0.05) and 105 (97–114) min (P<0.05), respectively. Similarly, intraperitoneal DEX (20 and 40 μg kg−1) increased the motor blockade from 48.5 (33–59) min to 88 (71–114) min (P<0.05) and 114.5 (103–156) min (P<0.05), respectively. Pre-treatment with yohimbine reduced the duration of motor block from 101.5 (83–115) to 76.5 (68–86) min (P<0.05) or from 114.5 (103–156) to 90 (83–93) min (P<0.05) when DEX was administered by the intrathecal or intraperitoneal routes. Motor block induced by spinal injection of LVB was prolonged by intrathecal and systemic administration of DEX, which was partially dependent on activation of alpha-2 adrenoceptors.