Indian Journal of Clinical Anaesthesia


Comparison of intrathecal dexmedetomidine and fentanyl on quality of subarachnoid block in patients undergoing lower abdominal surgeries: a randomized double blinded study


Full Text PDF Share on Facebook Share on Twitter


Author Details: Rashmi Suresh Patil, Vandana A Gogate, CS Sanikop

Volume : 3

Issue : 4

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 583

Article End Page : 587


Abstract

Background: Local anaesthetics have relatively short duration of action. Various adjuvants have been used to increase duration of block under subarachnoid block. The duration of surgical intervention varies from patient to patient and are associated with visceral manipulation causing somatic and visceral pain. Hence an attempt is made in this study to increase duration of block and also to cover postoperative analgesia by adding adjuvants to intrathecal bupivacaine. Alpha-2 adrenoceptor agonists act on dorsal horn of spinal cord and in combination with local anaesthetics increase the duration of sensory and motor block following subarachnoid block and also intrathecal opioids are known to prolong duration of subarachnoid block. The present study was done to compare the effects of intrathecal dexmedetomidine and fentanyl on duration of sensory and motor block and time for first post-operative analgesia.
Methodology: Sixty  patients of ASA I, II  scheduled for lower abdominal surgeries under subarachnoid block were allocated to receive either 10mg bupivacaine plus 5mcg dexmedetomidine [Group D, n=30] or 10mg bupivacaine plus 25mcg fentanyl [Group F, n=30] by double blinded  study after giving informed written consent. Level of block achieved, duration of sensory and motor block and time for first post operative analgesic was noted. Any >20% fall in BP was treated with ephedrine and heart rate <60bpm was treated with atropine.
Results: The study showed that Group D patients had  prolonged duration  of motor block for upto six hours and required analgesic  after nine hours following subarachnoid block where as in Group F patients duration of motor block was three  hours and required analgesic at three and half hour with statistical significance [p<0.05].
Conclusion: Dexmedetomidine when used intrathecally is a better alternative than intrathecal fentanyl for prolonging the duration of sensory and motor block as well as prolonging time for first post operative analgesic.

Keywords:
Dexmedetomidine, Fentanyl, Subarachnoid block, Analgesia