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Response to Queries on “Effects of intravenous dexmedetomidine on spinal anaesthesia and sedation – a comparison of two different maintenance infusions.”

 Department of Anaesthesia, BARC Hospital, Anushakti Nagar, Mumbai, Maharashtra, India

Date of Submission08-May-2020
Date of Acceptance14-Jun-2020
Date of Web Publication14-Sep-2020

Correspondence Address:
Pritee H Bhirud,
6/901, Sea Breeze Towers, Sec 16, Nerul (W), Navi Mumbai - 400 094, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/joacp.JOACP_232_20

How to cite this URL:
Bhirud PH, Chellam S. Response to Queries on “Effects of intravenous dexmedetomidine on spinal anaesthesia and sedation – a comparison of two different maintenance infusions.”. J Anaesthesiol Clin Pharmacol [Epub ahead of print] [cited 2020 Sep 18]. Available from:


To the Editor,

We thank the reader for showing interest in our study on the effects of intravenous dexmedetomidine on spinal anesthesia and sedation, and the editor for the opportunity to provide the clarification.[1]

Though the study was done in 2013-15, relevant references published till submission to the journal in 2018 were included. Regarding the query about the commonly accepted duration of intrathecal hyperbaric bupivacaine, the 55 min mentioned by us, clearly refers to two segment regression time of subarachnoid block and not the duration of intrathecal hyperbaric bupivacaine.[2] We stated the primary outcome at the end of the introduction, as per the convention followed by journals for research articles. It was to arrive at the dose of dexmedetomidine needed to prolong subarachnoid block (SAB) while ensuring adequate sedation.

Regarding the onset of sensory block, as rightly pointed out, the word “sensory block” should have been “sensorimotor block.” We apologize for the mistake. With respect to “high ASA status of patients in one of the groups,” we have included only ASA 1 and 2 patients in our study and their distribution was comparable in the two groups as shown in [Table 1] in the original article.(1) Duration and pain associated with different surgeries do vary; however, we included lower abdominal, infra-umbilical surgeries and lower limb surgeries which would be completed under SAB. As the patients were randomized to the two groups, various patient characteristics and surgery types are expected to be distributed similarly in the groups.{Table 1}

With respect to the clinical relevance of the findings, though a 10 min difference in duration of motor block is not a lot, it does have clinical relevance, e.g., in terms of discharge from PACU where every minute gained is desirable. Thanks for pointing out the “wide variation in dispersion” of duration of analgesia, and we agree that it is a limitation that we should have discussed. The likely reasons for it are the different types of procedures included in the study and the wide variation in the tolerance of pain in patients.

The statistical tests used for qualitative and quantitative data have been mentioned in “Materials and Methods.“ We chose to keep the title concise and specific so that the reader proceeds to the article with curiosity. It is desirable but not essential to include the type of study in the title. In addition, the “consort flow diagram” was submitted to the journal.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Bhirud PH, Chellam S, Mote MN, Toal PV. Effects of intravenous dexmedetomidine on spinal anesthesia and sedation – A comparison of two different maintenance infusions. J Anaesthesiol Clin Pharmacol 2020;36:78-82.  Back to cited text no. 1
[PUBMED]  [Full text]  
Harsoor SS, Rani DD, Yalamuru B, Sudheesh K, Nethra SS. Effect of supplementation of low dose intravenous dexmedetomidine on characteristics of spinal anaesthesia with hyperbaric bupivacaine. Indian J Anaesth 2013;57:265-9.  Back to cited text no. 2
[PUBMED]  [Full text]  


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