Comparison between intrathecal fentanyl and dexmedetomidine as an adjuvant to hyperbaric 0.5% levobupivacaine in subarachnoid block for cesarean section: A prospective study

Abstract

The effect of dexmedetomidine and fentanyl as an adjuvant with hyperbaric levobupivacaine in cesarean section has not been evaluated adequately by researchers until now. The present study is designed to compare the effect of 5 mcg of dexmedetomidine and 25 mcg fentanyl when added to intrathecal 0.5% hyperbaric levobupivacaine for cesarean section. This randomized controlled trial was done with 105 parturient undergoing cesarean section under spinal anesthesia. Parturient were randomly divided into three groups. Group DL received 5 mcg of dexmedetomidine along with 1.8 ml of hyperbaric levobupivacaine intrathecally. Group FL and group NL received 25 mcg of fentanyl and 0.5 ml of normal saline respectively along with 0.5% hyperbaric levobupivacaine. The primary objective was to compare the duration of sensory and motor block among the groups. Comparing the onset time of sensory and motor block and time to first analgesic medication was considered a secondary objective. Duration of sensory block was 138.14 ± 14.35 and 131.86 ± 7.85 min in group DL and FL (P < 0.05). Motor block duration was 250.2 ± 6.86 and 242.63 ± 4.71 min in group DL and FL respectively (P < 0.05). The time to first analgesic medication in group DL (273.43 ± 7.54 vs. 253.43 ± 6.52 min) was significantly prolonged compared to group FL (P < 0.001). A 5 mcg dose of dexmedetomidine when used as an adjuvant to intrathecal 0.5% hyperbaric levobupivacaine significantly prolongs the duration of sensory block, motor block, and the time to first analgesic medication compared to 25 mcg of fentanyl.

Keywords

• anesthesia
• spinal
• adjuvants, anesthesia
• caesarean section
• dexmedetomidine
• fentanyl
• levobupivacaine