Key points are not available for this paper at this time.
Background: Spinal anaesthesia is one of the most popular techniques for both elective and emergency lower abdominal surgical procedures. Spinal anaesthesia with a local anaesthetic agent alone is sometimes offset by a relatively short duration of action. To overcome this, several adjuvants are added to the local anaesthetic agent. We aimed to study the effectiveness of dexmedetomidine versus fentanyl as an adjuvant with bupivacaine for spinal anaesthesia in infra-umbilical gynaecological surgeries. Methods: This prospective double-blind, randomised study included 100 patients divided equally into 2 groups (group BD- dexmedetomidine and group BF-fentanyl). Group BD received 0.5% hyperbaric bupivacaine 15 mg + 5 µg Dexmedetomidine and Group BF received 0.5% hyperbaric bupivacaine 15 mg + 25 µg fentanyl intrathecally. The onset, duration of sensory and motor block along with duration and quality of analgesia were recorded. Results: The mean time for onset of sensory block (group BD 3.0±0.97 minutes vs. group BF 3.15±0.99 minutes) and the mean time for motor onset blockade (BD 6.10±1.25 minutes vs. BF 5.54±1.05 minutes) were statistically insignificant. Duration of sensory block (BD 301.06±17.53 minutes vs. BF 208.80±13.42 minutes) and duration of motor block (BD 270.90±17.40 minutes vs. BF, 179.68±10.68 minutes) were statistically significant. Intraoperative analgesia was comparable while post-op analgesia was significantly longer in Group BD. Conclusion: From our study, we concluded that Dexmedetomidine is an attractive alternative to Fentanyl as it provides rapid onset and prolonged sensory and motor block, excellent intra and postoperative analgesia with stable haemodynamics.
Shetty et al. (Mon,) studied this question.