Comparative Study of Intrathecal Dexmedetomidine and Fentanyl as Adjuvants to Bupivacaine Regarding Onset of Sensory, Duration of Motor Blockade and Requirement of Post-Operative Analgesia.
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 5522-5531
AbstractBackground:Sub Arachnoid block is the safe, satisfactory and most commonly used technique for lower abdominal, pelvic and lower limbs surgeries. The duration of action of Bupivacaine is prolonged; it may not produce adequate post-operative analgesia. Hence adjuvants were used for producing prolonged post-operative analgesia. The aims and objective is to Compare the onset, duration of sensory and motor blockade and requirement of post-operative analgesia with dexmedetomidine vs fentanyl as adjuvants to intrathecal 0.5% hyperbaric bupivacaine Secondary Objectives were compare the hemodynamic effects of adding dexmedetomidine vs fentanyl as adjuvants to intrathecal bupivacaine.
Materials and Methods: Patients were allocated into one of the three groups of 50 each using computer generated random number. Patients were counselled regarding the procedures.
Results: The Onset of Sensory Block amongst the groups was statistically insignificant with P-Value of 0.279.), The mean duration of motor block was 231.16±68.56, 263±64.46 and 178.52±26.60 mins in Groups A, B and C respectively. The prolonged motor block in Group B (Dexmedetomidine) was statistically significant with P-Value of <0.0001. The mean time for first rescue analgesia was 323.44±116.29 mins in Group A, 391.52±105.63 mins in Group B and 311.80±99.15 mins in Group C. Better post-operative analgesia in Group B, P value of <0.0001.
Conclusion: From this study it can be concluded that the use of intrathecal dexmedetomidine as an adjuvant to bupivacaine seems to be a better alternative to fentanyl for long duration surgical procedures due to its prolonged duration of sensory and motor block combined with minimal side effects. However, prolonged duration of motor blockade with dexmedetomidine may be undesirable for shorter surgical procedures or ambulatory surgeries.
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