الفهرس 
Chapter (1): Anesthetic management of obese patientsOnly 14 pages are availabe for public view
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Abstract
Obese patients undergoing surgeries usually have their perioperative pain under managed, as anesthesia and pain management providers are cautious about the side effects of opioid use as; respiratory depression, nausea, vomiting.
Intrathecal dexamedetomidine had been found to produce dose dependent anti- nociception effect due to a suggested mechanism by supraspinal action sites secondary to systemic absorption of the drug.
The aim of the study is to compare between the effects of intrathecal dexamedetomidine as adjuvant to hyperbaric bupivacaine and hypebaric bupivacaine only as a part of multimodal regimen on perioperative pain management in laparoscopic bariatric surgeries.
This study included 40 patients between 20-50 years old, ASA II/III underwent elective underwent laparoscopic bariatric surgeries. Patients were randomized equally to two groups (n=20). Both groups received general anesthesia plus intrathecal 0.5% bupivacaine 1.3 ml. ” ” " ~ " ” ” 6.5mg and 10 ug Dexamedetomidine total 1.5 ml or hyperperbaric bupivacaine 0,5% 1.3 ml” ” " ~ " ” ”6.5mg (control group).
The primary outcome of the study was the total 24hours morphine dose consumption in mg. Also the study compared VAS in form of more than 3 centimeter vertical line at 0, 0.5, 1, 2, 4, 6, 8, 12, 24 hours.
Secondary outcome of this study:
Intraoperative monitoring hemodynamics, postoperative early ambulation, Postoperative sedation score using Ramesy Score, Postoperative nausea, any adverse effects, Length of hospital stay and Patient satisfaction.
Using intrathecal dexamedetomidine decreased postoperative morphine consumption and postoperative pain in adult undergoing bariatric laparoscopic surgeries in comparison to general anesthesia alone. Also, time of first analgesia required was longer in dexamedetomidine group.
Regarding hemodynamics, intrathecal dexamedetomidine showed lower intraoperative heart rate with comparable mean arterial blood pressure.
Intrathecal dexamedetomidine has more favorable outcomes than general anesthesia alone including early ambulation time, shorter length of stay in hospital and higher patient satisfaction score.