{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T23:21:31Z","timestamp":1781911291044,"version":"3.54.5"},"reference-count":28,"publisher":"Termedia Sp. z.o.o.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anaesthesiol Intensive Ther"],"abstract":"Introduction<\/jats:title>Dexmedetomidine is administered intravenously, intrathecally, and\nintramuscularly to enhance the effect of subarachnoid anesthesia. In this study, we\ninvestigated the effect of intranasal dexmedetomidine on the characteristics of spinal\nanesthesia.<\/jats:p><\/jats:sec>Material and methods<\/jats:title>In this double-blinded randomized control study, 60 patients undergoing\northopedic surgery under spinal anesthesia were allocated to two groups. Group A\n\nreceived intranasal dexmedetomidine 1 \u03bcg kg<sup>\u20131<\/sup> 20 minutes (min) before the subarachnoid block. Group B received intranasal normal saline 20 min before the subarachnoid\n\nblock. Time for the onset of sensory and motor blockade, two-segment regression time,\nand request of first rescue analgesia were noted. Sedation scores using the Ramsay\nSedation Scale (RSS), adverse effect and hemodynamic parameters were assessed.<\/jats:p><\/jats:sec>Results<\/jats:title>The onset of sensory block and motor block did not differ significantly between\nthe groups. However, two-segment regression time was significantly longer in Group A\nthan in Group B (113.17 \u00b1 14.11 min vs. 94.13 \u00b1 9.59 min, respectively; <i>P<\/i> < 0.001), and\nthe time for first rescue analgesia was significantly longer in Group A than in Group B\n(3.97 \u00b1 1.56 min vs. 2.56 \u00b1 0.76 min, respectively; <i>P<\/i> < 0.001). The overall mean heart\nrate and mean arterial pressure were comparable between the two groups with stable\n\nhemodynamics. The visual analogue scale score in Group A was low (P < 0.001). Intraoperatively, at 30 min and 60 min, the change in RSS score was found to be statistically\n\nsignificant (<i>P<\/i> < 0.001).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Intranasal dexmedetomidine prolongs the effect of subarachnoid anesthesia, provides stable hemodynamics with arousable sedation, and offers a noninvasive, better-tolerated alternative compared to other invasive routes of administration.<\/jats:p><\/jats:sec>","DOI":"10.5114\/ait\/200240","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T19:50:46Z","timestamp":1752177046000},"page":"139-147","source":"Crossref","is-referenced-by-count":1,"title":["Effect of preoperative intranasal dexmedetomidine on characteristics of spinal anesthesia with hyperbaric bupivacaine for lower limb orthopedic surgery: a double-blinded randomized control study"],"prefix":"10.5114","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7472-9580","authenticated-orcid":false,"given":"Sandeep","family":"Gade","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1632-7345","authenticated-orcid":true,"given":"Jitendra V","family":"kalbande","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0065-0639","authenticated-orcid":false,"given":"Swati K","family":"Vijapurkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8211-253X","authenticated-orcid":false,"given":"Samarjit","family":"Dey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandkishore","family":"Agrawal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3061","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"ref-1473434","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v13.i1.11"},{"key":"ref-1473435","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2017\/26241.9654"},{"key":"ref-1473436","doi-asserted-by":"publisher","DOI":"10.5812\/aapm.12738"},{"key":"ref-1473437","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000596"},{"key":"ref-1473438","doi-asserted-by":"crossref","unstructured":"Yoo H, Iirola T, Vilo S, Manner T, Aantaa R, Lahtinen M, et al. Mechanism-based population pharmacokinetic and pharmacodynamic modeling of intravenous and intranasal dexmedetomidine in healthy subjects. Eur J Clin Pharmacol 2015; 71: 1197-1207. DOI: 10.1007\/ s00228-015-1913-0.","DOI":"10.1007\/s00228-015-1913-0"},{"key":"ref-1473439","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e328305e3ef"},{"key":"ref-1473440","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9185.83670"},{"key":"ref-1473441","doi-asserted-by":"publisher","DOI":"10.4103\/1658-354X.130719"},{"key":"ref-1473442","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198907000-00014"},{"key":"ref-1473443","unstructured":"Talgaonkar S, Mishra PR. Intranasal delivery: an approach to bypass the blood brain barrier. India J Pharmacol 2004; 36: 140-147."},{"key":"ref-1473444","doi-asserted-by":"crossref","unstructured":"Wolfe TR, Braude DA. Intranasal medication delivery for children: a brief review and update. Pediatrics 2010; 126: 532-537. DOI: 10.1542\/ peds.2010-0616.","DOI":"10.1542\/peds.2010-0616"},{"key":"ref-1473445","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-011-1002-y"},{"key":"ref-1473446","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9185.111680"},{"key":"ref-1473447","doi-asserted-by":"crossref","unstructured":"Ankita, Kumar H, Kumar M. Comparison of intranasal versus intravenous dexmedetomidine to attenuate haemodynamic response of laryngoscopy and endotracheal intubation in elective lumbar spine surgery: a randomized control study. 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Intrathecal versus intravenous dexmedetomidine in characteristics of bupivacaine spinal block in lower abdominal surgery. Menoufia Med J 2016; 29: 523-529.","DOI":"10.4103\/1110-2098.198694"},{"key":"ref-1473454","unstructured":"Bhashyam S, Kumar GP, Sagar TP, Gayathri S. Effects of intramuscular dexmedetomidine versus clonidine on the duration of subarachnoid block and analgesia for lower limb orthopedic surgeries. 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