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Comparative Studies | Anaesthesiology | Volume 15 Issue 4, April 2026 | Pages: 475 - 480 | India
Comparative Study of the Efficacy of Intrathecal Fentanyl with Intrathecal Dexmedetomidine as Adjuvants to Hyperbaric Levobupivacaine 0.5% in Patients Undergoing Infraumbilical Surgeries: A Double Blind Randomised Control Study
Abstract: Intrathecal adjuvants are commonly used to enhance the quality and duration of spinal anaesthesia. This study aimed to compare dexmedetomidine with fentanyl as adjuvants to hyperbaric levobupivacaine in patients undergoing infraumbilical surgeries. Materials and Method: This prospective, randomized, double-blind study included 70 patients undergoing infraumbilical surgeries. Patients were divided into two groups: a) Group A: levobupivacaine + fentanyl 25 ?g b) Group B: levobupivacaine + dexmedetomidine 5 ?g. The study assessed the onset of sensory and motor block along with the duration of sensory and motor block. Vital parameters were closely monitored intraoperatively and postoperatively along with the post-surgical pain using the VAS score1(Visual Analogue Scale). Results: Sensory and motor block onset times were similar in both groups. However, dexmedetomidine group showed significantly prolonged sensory block duration of 462.34?±?50.18 minutes vs. 180.94?±?3.56 minutes in fentanyl group and motor block duration 415.11?±?46.73 minutes vs. 144.8?±?3.45 minutes across the two groups B and A respectively. Intra operative heart rate and oxygen saturation showed no significant fluctuations across both groups. While systolic, diastolic, and mean arterial pressures showed transient statistically significant elevations in the dexmedetomidine group, they remained clinically stable. The rescue analgesic was required 6.00?±?1.59 hours in group B vs. 1.90?±?0.68 time in hours in group A. Additionally, the mean VAS1 pain scores during the first 3 hours postoperatively was significantly higher in Group A 2.46±2.23 as compared to Group B 0.21±1.14 with p < 0.0001, indicating superior postoperative pain control. Conclusion: Both agents are safe, with stable haemodynamics and minimal side effects. While onset of sensory and motor block times is comparable, dexmedetomidine significantly lengthened the duration of sensory and motor block, delayed the need for rescue analgesia, and provided superior pain control in the intraoperative and postoperative period without significant haemodynamic instability. These outcomes demonstrated the efficacy of dexmedetomidine more effective for surgeries requiring prolonged analgesia, whereas fentanyl remains suitable for shorter procedures with faster recovery goals.
Keywords: Dexmedetomidine, fentanyl, spinal anaesthesia, levobupivacaine, intrathecal adjuvants, infraumbilical anaesthesia
How to Cite?: Dr. Rachel Divya Braganza, Dr. Valsamma Abraham, "Comparative Study of the Efficacy of Intrathecal Fentanyl with Intrathecal Dexmedetomidine as Adjuvants to Hyperbaric Levobupivacaine 0.5% in Patients Undergoing Infraumbilical Surgeries: A Double Blind Randomised Control Study", Volume 15 Issue 4, April 2026, International Journal of Science and Research (IJSR), Pages: 475-480, https://www.ijsr.net/getabstract.php?paperid=SR26404221817, DOI: https://dx.dx.doi.org/10.21275/SR26404221817