A Comparative Study Of Intrathecal Fentanyl Versus Intrathecal Dexmedetomidine As An Adjuvant To Hyperbaric Bupivacaine In Infra-Umbilical Surgries


  • Jigisha Mehta, Tejas Sanghavi, Jatin Patel, Lokesh Jain, Dinesh Chauhan


Bupivacaine, Dexmedetomidine, Fentanyl, Spinal anesthesia


INTRODUCTION: Lower abdomen and lower limb procedures are best performed under spinal anaesthetic. Due to its lower neurotoxicity, bupivacaine is the most often used local anaesthetic for subarachnoid blocking. In order to extend the benefits of spinal analgesia, many adjuvants are administered.

Materials and methods: A comparative observational study was conducted among 44 patients undergoing infra-umbilical surgeries under spinal anesthesia. Patients were grouped into Group BD (Bupivacaine + Dexmedetomidine group) & Group BF (Bupivacaine + Fentanyl) with 22 patients in each group. Spinal anesthesia was given as per protocol under aseptic precautions. Sensory and motor analgesia was noted as per the pin prick method and Bromage grade, respectively. Intraoperative assessment and management of adverse events were performed where required. Post-operative pain assessment was done by using visual analogue scale. Duration of analgesia was noted.

Results: The mean onset of sensory block at was 2.5 ± 0.7 minutes in Group BF while 1.9 ± 0.6 minutes in the BD group. The mean time for onset of motor block was 4.22 ± 0.68 min in Group BF while 2.86 ± 0.71 minutes in the participants of BD group, the mean duration of sensory block was 222.18 ± 12.64 minutes in BF group while it was 369.54 ± 23.39 minutes in BD group, the mean duration of motor block was 170.8 ± 18.24 minutes in BF group while it was 304.09 ± 21.30 minutes in BD group, the mean duration of analgesia was 221.54 ± 15.00 minutes in BF group while it was 421.36 ± 25.31 minutes in BD group.

Conclusion: The onset of sensory block and motor block was faster in dexmedetomidine than fentanyl with bupivacaine. Duration of sensory, motor block and duration of analgesia was significantly longer in the dexmedetomidine with bupivacaine group than in fentanyl.