Opioids are the most used intrathecal (IT) adjuvants in lower segment caesarean section (LSCS); however, they are associated with side effects for both mothers and neonates. Dexmedetomidine (Dex) is one of the novel drugs and has been used as an IT adjuvant with success. This meta-analysis aimed to assess the usefulness of IT Dex and IT fentanyl in patients undergoing LSCS. The included studies in this study reported the onset and duration of spinal block, opioid consumption, first request to analgesia, pain control, and adverse effects. Sensory block (SB) onset was significantly faster with IT Dex (95% CI: -0.43 -0.02, p = 0.03). The SB duration was significantly longer in the IT Dex group. Also, the first request for analgesia was considerably longer by 81.74 minutes in IT Dex (95% CI: 63.03-100.45, p <0.001). IT Dex fastens the SB onset and increases its duration compared to IT fentanyl in LSCS. It significantly increases the time to first analgesic request. IT Dex also resulted in a lower incidence of shivering than IT fentanyl. Key Words: Intrathecal dexmedetomidine, Fentanyl, Caesarean delivery, Opioid consumption, Sensory block, Motor block.
Huda et al. (Mon,) studied this question.