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Comparative Studies | Anaesthesiology | India | Volume 14 Issue 3, March 2025 | Popularity: 5.4 / 10
Comparison of Dexmedetomidine and Fentanyl as Adjuvants to Intrathecal Levobupivacaine in Patients Undergoing Infra-Umbilical Surgeries
Dr. Pulak Kumar Sahoo, Dr. Sucheta Pattanayak
Abstract: Background: Spinal anaesthesia is a common technique for infra-umbilical surgeries; however, its limited duration necessitates rescue analgesics. Aim: To compare the efficacy of Fentanyl (25mcg) vs. Dexmedetomidine (5mcg) as adjuvants to intrathecal Hyperbaric Levobupivacaine in infra-umbilical surgeries with respect to characteristics of spinal blockade, hemodynamic effects, post-op analgesia, sedation, motor block duration, and adverse effects. Study Design: Prospective, Randomized & Double-blind study. Material And Methods: The study was conducted at Hi-Tech Medical College & Hospital, Bhubaneswar, from March 2023 to February 2025. The study included 120 ASA I and II patients of either sex, aged 18-60 years, scheduled for elective infra-umbilical surgeries. Patients were randomly assigned to two groups: Group D: 0.5% Hyperbaric Levobupivacaine 2.5 ml + 5 mcg Dexmedetomidine. Group F: 0.5% Hyperbaric Levobupivacaine 2.5 ml + 25 mcg Fentanyl Haemodynamic Parameters such as Heart Rate, Systolic Blood Pressure, Diastolic Blood Pressure, Mean Arterial Pressure, SpO2, were recorded at baseline. Spinal anaesthesia was administered at the L3-L4 interspace. Vitals and block characteristics were monitored at specified intervals intraoperatively and postoperatively. Side effects were documented and managed accordingly. Postoperative rescue analgesia was given as per requirement. Results and Discussion: This prospective, randomized, double-blind study compared the effects of Dexmedetomidine (5 mcg) and Fentanyl (25 mcg) as adjuvants to 0.5% hyperbaric Levobupivacaine in 120 patients undergoing infra-umbilical surgeries. The findings indicate that Dexmedetomidine significantly prolongs sensory and motor blockade, provides superior postoperative analgesia, and delays rescue analgesia requirements compared to Fentanyl (p<0.0001). Both drugs exhibited comparable side effects, with Dexmedetomidine offering an opioid-sparing benefit without significant hemodynamic instability. These results suggest Dexmedetomidine as a more effective intrathecal adjuvant for infra-umbilical procedures." Conclusion: Intrathecal Dexmedetomidine with 0.5% hyperbaric Levobupivacaine provided superior surgical and prolonged postoperative analgesia with faster onset and extended sensory-motor blockade. It demonstrated opioid-sparing benefits without significant hemodynamic instability, making it an effective adjuvant for infra-umbilical surgeries.
Keywords: Spinal anaesthesia, Intrathecal adjuvants, Dexmedetomidine, Fentanyl, Postoperative analgesia
Edition: Volume 14 Issue 3, March 2025
Pages: 683 - 687
DOI: https://www.doi.org/10.21275/SR25312213953
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