Dexmedetomidine and Fentanyl as Adjuvants to Hyperbaric Bupivacaine 0.5% in Gynaecological Surgery

What is it about?

Dexmedetomidine and Fentanyl as Adjuvants to Hyperbaric Bupivacaine 0.5% in Gynaecological Surgery

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Why is it important?

Background: Regional anesthesia is the preferred technique for most of lower abdominal and lower limb surgeries as it allows the patient to remain awake and minimizes or completely avoids the problem associated with airway management. Hyperbaric bupivacaine 0.5% is extensively used for spinal anesthesia. Fentanyl is a synthetic lipophilic opioid commonly used for postoperative analgesia. Aim: The aim of the study is to compare the following factors in two groups i.e. Hyperbaric bupivacaine 0.5% and 5 mcg Dexmedetomidine and Hyperbaric bupivacaine 0.5% and 25 mcg Fentanyl when given intrathecally. Materials and Methods: This randomized controlled trial was designed to evaluate the onset and duration of sensory and motor block as well as operative analgesia and adverse effects of Dexmedetomidine vs Fentanyl given intrathecally with heavy 0.5% Bupivacaine for spinal anesthesia in patients scheduled for Total Abdominal hysterectomy patients receiving 5 mcg of Dexmedetomidine and 25 mcg of Fentanyl with 3 ml of Bupivacaine intrathecally. Results: The addition of Dexmedetomidine significantly prolonged the duration of sensory and motor block, significantly prolonged the time for demand analgesia and had no effect on the onset of sensory or motor block when compared with fentanyl. The incidence of side effects was limited to the occurrence of Hypotension, Bradycardia, vomiting in the groups that received Dexmedetomidine intrathecally. The incidence of pruritus were more in the groups that received fentanyl intrathecally. The addition of Dexmedetomidine intrathecally had similar effect on sedation when compared to fentanyl.

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