COMPARATIVE STUDY BETWEEN INTRATHECAL BUPIVACAINE WITH DEXMEDETOMIDINE AND INTRATHECAL BUPIVACAINE WITH FENTANYL FOR LOWER ABDOMINAL SURGERIES. A RANDOMIZED DOUBLE BLINDED CONTROLLED CLINICAL TRIAL
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Spinal anaesthesia is preferred choice of anaesthesia in lower abdominal surgeries since long time. Various adjuvants have been used with local anaesthetics in spinal anaesthesia to provide prolonged postoperative analgesia. Dexmedetomidine, the new highly selective α2-agonist drug, is now being used as a neuraxial adjuvant. This prospective, randomized, double blinded study was conducted to evaluate the onset, duration of sensory and motor blockade, haemodynamic stability and
... tability and adverse effects of dexmedetomidine and fentanyl when given intrathecally with 0.5% hyperbaric bupivacaine. MATERIALS AND METHODS A total of 60 patients of ASA I and II scheduled for elective lower abdominal surgeries were selected and randomly allocated into 2 groups of 30 each. Group D received 0.5% hyperbaric bupivacaine (15 mg) plus dexmedetomidine (10 μg), Group F received 0.5% hyperbaric bupivacaine (15 mg) plus 25 μg fentanyl intrathecally. The onset of sensory and motor blockade, duration of sensory and motor blockade, duration of analgesia, haemodynamic changes and side effects (Nausea, vomiting, pruritus, respiratory depression, bradycardia or hypotension) were recorded. RESULTS Onset of sensory blockade was faster in fentanyl group than dexmedetomidine group, but this was statistically insignificant. Patients in dexmedetomidine group (D) had faster motor onset (p<0.01) and significantly longer sensory and motor blockade time than patients in fentanyl group (F) (p<0.01). Duration of analgesia was better with dexmedetomidine (p<0.01). There were no significant haemodynamic changes or adverse effects in any of the groups. It was observed that sedation was better in Group D. CONCLUSIONS Intrathecal Dexmedetomidine is a better adjuvant than intrathecal Fentanyl with prolonged sensory and motor blockade and profound postoperative analgesia. KEYWORDS 0.5% Hyperbaric Bupivacaine, Dexmedetomidine, Fentanyl. HOW TO CITE THIS ARTICLE: Leelavathy PB, Iqbal S, Fathima A. Comparative study between intrathecal bupivacaine with dexmedetomidine and intrathecal bupivacaine with fentanyl for lower abdominal surgeries. A randomized double blinded controlled clinical trial.