Comparative study of adding fentanyl or dexmedetomidine or morphine as adjuvant for intrathecal bupivacaine for caesarean sections
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 4060-4065
Abstract
Background: Caesarean section is one of the most commonly performed surgical procedures worldwide and 80–90% of them are performed under spinal anaesthesia.Adding adjuvants drugs to intrathecal local anaesthetics improves quality and duration of spinal blockade, and prolongs postoperative analgesia. The aim of our study was to compare the efficacy of using intrathecal Fentanyl, morphine and Dexmedetomidine as adjuvants to Bupivacaine in patients undergoing caesarean section at a tertiary hospital.Material and Methods: Present study was comparative study, conducted among pregnant women, 20-35 years age, ASA grade I/II, posted for elective Caesarean section. Patients received either Fentanyl or Morphine or Dexmedetomidine as adjuvants with Intrathecal Bupivacaine (H) 0.5% 10mg (2ml) with as a standard dose.
Results: In present study, 99 pregnant women, equally allotted (33 each) to each group (i.e. Group BF, Group BM & Group BD). Mean age & duration of surgery was comparable among all 3 groups & difference was not statistically significant (p>0.05). Onset of action (Group BD- 43.3 ± 10.22 secs < Group BF - 50.15 ± 10.56 secs < Group BM - 51.4 ± 9.46 secs) & Duration of analgesia (Group BD- 460.2 ± 40.27 mins > Group BM - 326.2 ± 32.92 mins> Group BF - 292.8 ± 34.61 mins) was significantly better in dexmedetomidine group as compared to fentanyl group & morphine group, difference was statistically significant (p<0.05). Maternal vitals (pulse rate, systolic blood pressure & diastolic blood pressure) were stable throughout surgery & early postoperative period among all 3 groups, difference was not statistically significant (p>0.05).
Conclusion: Intrathecal dexmedetomidine as an adjuvant to bupivacaine has early onset of action, prolonged post-operative analgesia combined with minimal side effects.
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