Intrathecal dexmedetomidine versus morphine as adjuvant to bupivacaine in elective LSCS: a comparative study

• Author Details:   
• Soumya Samal
• Shaswat Kumar Pattnaik
• Ankita Mohta
• Saubhagya Kumar Jena

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Introduction: Postoperative analgesia is very essential for the postpartum women as it enables faster rehabilitation and initiation of breastfeeding. Spinal anaesthesia is most commonly used anaesthetic technique. So, we tried to compare the efficacy of dexmedetomidine and morphine as adjuvant to bupivacaine in lower segment caesarean section.
Methods: This prospective comparative study was conducted on sixty parturients of ASA grade I and II scheduled for elective lower segment caesarean section under spinal anaesthesia. Cases were randomly divide into two groups: Group D received 12.5 mg of 0.5% hyperbaric bupivacaine with 5 µgdexmedetomidine and Group M received 12.5 mg of 0.5% hyperbaric bupivacaine with 125 µg morphine. Parameters recorded were the duration of time to achieve T8 sensory blockade, the time to S1 level sensory regression, the time of motor regression to Bromage 0, the time to first rescue analgesia and incidence of side effects.
Results: The mean time of sensory block to reach T8 dermatome was significantly faster in group D (p=0.00004). The mean time of sensory regression to S1 and motor regression to reach modified Bromage 0 was significantly longer in group D (p<0.05). Both 1 & 5 min APGAR were similar in both the groups. Although the time to first rescue analgesia was longer in group D, it was statistically not significant. Side effects were more in group M.
Conclusion: Prolong postoperative analgesia with minimal side effects makes 5 µg dexmedetomidine as an alternative to125 µg morphine as adjuvant to spinal bupivacaine in caesarean section.