Comparative Evaluation of Intrathecal Dexmedetomidine and Fentanyl with Hyperbaric Bupivacaine for Post-Operative Analgesia in Lower Abdominal Surgeries

Abstract

Background: Spinal anaesthesia is the fastest and most reliable form of regional anaesthesia. Additions of intrathecaly adjuvants are useful for prolonging the spinal anaesthesia effects. Subjects and Methods: The Patients were divided in three groups; Group C (control group) = received 15 mg (3 ml) of hyperbaric bupivacaine intrathecaly. Group D = received 15 mg (3 ml) of hyperbaric bupivacaine plus 4μg Dexmedetomidine intrathecally. Group F = received Hyperbaric Bupivacaine 15mg (3ml) plus 25μg fentanyl intrathecally. Results: For the total duration of sensory block p-value is 0.000003, which is less than 0.05 (α) and is highly significant. From the above p -value and scheffe post hoc test we conclude that the Bupivacaine + Dexmedetomidine has prolonged duration of sensory block as compared to bupivacaine alone and in combination with fentanyl. For the motor block p-value is 0.000000 and is less than 0.05 (α). It is highly significant. For the demand of Analgesic p-value is 0.0000001 and is less than 0.05 (α) i.e. there is highly significant difference between them. Conclusion: Intrathecal Dexmedetomidine used as an adjuvant to bupivacaine in spinal block seems to be a good alternative to intrathecal fentanyl as it produces early onset and prolonged duration of sensory and motor block without significant haemodynamic alteration and side effects.