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Comparison of intrathecal dexmedetomidine and intrathecal fentanyl as an adjuvant with hyperbaric bupivacaine for spinal anaesthesia in lower limb surgeries: A prospective randomized clinical trial

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Original Article

Author Details : Sudhir Sachdeva, Khushbu M Parekh, Aman Malawat*, Durga Jethava, Taslim Mansuri

Volume : 7, Issue : 2, Year : 2020

Article Page : 226-232

https://doi.org/10.18231/j.ijca.2020.041

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Abstract

Background and Aim: Subarachnoid block is the most common technique employed for lower limb
surgeries. When used as an adjuvant to intrathecal local anaesthetic, both fentanyl and dexmedetomidine
have the ability increase perioperative analgesia. This study aimed to compare and evaluate the effective
profile of dexmedetomidine and fentanyl as an adjuvant to intrathecal bupivacaine in lower limb surgeries.
Materials and Methods: In this clinical trial, 90 patients undergoing elective lower limb surgeries under
spinal anaesthesia were randomly allocated to two groups. In group BD, the patients received 0.5%
hyperbaric bupivacaine 12.5 mg + dexmedetomidine 5 mcg. In group BF, the patients received 0.5%
hyperbaric bupivacaine 12.5 mg + fentanyl 25 mcg. Onset, duration, regression of sensory and motor
blockade along with haemodynamic variations and side effects were compared between both the groups.
Results: The onset of sensory block was earlier in Group BD, while the onset of motor block was
earlier in Group BF. However, the differences with the onset of sensory and motor block remained
statistically insignificant (P = 0.4988 and 0.4918). The mean time for two-segment sensory regression,
time for regression to L1 dermatome and duration of motor block was significantly less in Group BF.
The analgesic requirement in the early postoperative period and the haemodynamic variation remained
statistically insignificant in both the groups.
Conclusion: Intrathecal dexmedetomidine provided prolonged sensory as well as motor blockade thereby
enhancing postoperative analgesia.

Keywords: Adjuvants, Bupivacaine, Fentanyl, Dexmedetomidine.

How to cite : Sachdeva S, Parekh K M, Malawat A, Jethava D, Mansuri T, Comparison of intrathecal dexmedetomidine and intrathecal fentanyl as an adjuvant with hyperbaric bupivacaine for spinal anaesthesia in lower limb surgeries: A prospective randomized clinical trial. Indian J Clin Anaesth 2020;7(2):226-232

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