A comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to bupivacaine to provide prolonged postoperative analgesia

Abstract

Background and Objectives: Mixing adjuvants with hyperbaric bupivacaine for intrathecal injection is an practice since long time for reducing dose requirement of bupivacaine and prolongation of duration of action. Short acting liophilic opioid fentanyl and selective apha2 agonist dexmedetomidine is used to reduce dose requirement of bupivacaine and its adverse effects and also to prolong postoperative analgesia. The main objective of the study is to compare efficacy of intrathecal adjuvants i.e., dexmedetomidine and fentanyl with hyperbaric bupivacaine to assess postoperative analgesia and side effects Materials and Methods: This prospective, randomized, double blinded and placebo control study was carried out in a tertiary health care centre on 105 patients by randomly allocated into 3 groups and were assigned to receive one of the three intrathecal drugs i.e., Group D (n=35) received mixture of 0.5% hyperbaric bupivacaine (2.5ml) with Dexmedetomidine (5mcg) intrathecally, Group F(n=35) received mixture of 0.5% hyperbaric bupivacaine (2.5ml) with (25mcg) of fentanyl intrathecally and Group B received 0.5% hyperbaric bupivacaine (2.5ml) and 0.5ml normal saline intrathecally. All the solutions were made up to volume of 3ml in a 5ml syringe. Results: The duration of analgesia was significantly longer in Group D (545±61.94) compare to Group F (437.94±43.32) and Group B (263.97±22.88). Conclusion: Dexmedetomidine an adjuvant to bupivacaine (H) found to be very attractive alternative to fentanyl as it provides excellent postoperative analgesia