To determine the efficacy of intrathecal dexmedetomedine and fentanyl as adjuvants to spinal anesthesia for lower abdominal surgeries below the level of umbilicus - A prospective randomized controlled double blinded study

Abstract

Background: Spinal anesthesia is widely used regional anesthesia technique; however, postoperative analgesia is a major problem. The duration of analgesia can be prolonged by the addition of intrathecal adjuvants. Hence, this study is aimed to assess the characteristics of spinal block between the groups. Patients and Methods: One hundred and twenty-six adult patients were enrolled in this study. Patients were randomized into three groups of 42 in each group by the computer-generated numbers. Group A received 12.5 mg of 0.5% bupivacaine (2.5 ml) + 25 mcg fentanyl (0.5 ml), Group B received 12.5 mg of 0.5% bupivacaine (2.5 ml) + 5 mcg dexmedetomidine (0.1 ml) + 0.4 ml normal saline (NS), and Group C received 12.5 mg of 0.5% bupivacaine (2.5 ml) + 0.5 ml NS. Block characteristics and hemodynamic changes were recorded between the groups. Results: Time to achieve sensory block (T10) and motor block (M1) were faster in Group B when compared to Group A and C (P < 0.001). Duration of sensory block and motor block was longer with Group B (450.12 ± 22.295 min and 390.12 ± 22.551 min) when compared to Group A (380.71 ± 13.331 min and 320.71 ± 13.403 min) and Group C (220.10 ± 14.635 min and 180.10 ± 14.355 min). Time for first rescue analgesia was also longer in Group B when compared to Groups A and C (P < 0.001). Conclusion: Intrathecal dexmedetomidine provides effective prolongation of sensory and motor block as adjuvant to hyperbaric bupivacaine in spinal anesthesia.

Keywords

• dexmedetomidine
• fentanyl
• intrathecal adjuvants
• lower abdominal surgeries
• spinal anesthesia