A COMPARATIVE STUDY OF INTRATHECAL DEXMEDETOMIDINE AND FENTANYL AS ADJUVANTS TO BUPIVACAINE FOR INFRA-UMBILICAL SURGERIES

BACKGROUND: Several adjuncts like adrenaline, opioids and alpha-2 adrenergic agonists are being used with local anaesthetics intrathecally for prolongation of intra-operative and post-operative analgesia and to reduce the side-effects of high doses of local anaesthetics.[1] AIM: The present study was done to evaluate the onset and duration of sensory and motor block, hemodynamic effects, post-operative analgesia and adverse effects of Dexmedetomidine or Fentanyl given intrathecally with hyperbaric 0.5% Bupivacaine. MATERIALS AND METHODS: Ninety inpatients of ASA class I and II scheduled for various infra-umbilical surgeries under Sub-Arachnoid Block were randomly divided into three groups of 30 each namely C (Control), D(Dexmedetomidine) and F(Fentanyl). All received 12.5mg hyperbaric bupivacaine plus 0.5 ml Normal Saline in Group C(Control), 5 mu g Dexmedetomidine (diluted in preservative free Normal saline of 0.5ml) in Group D(Dexmedetomidine) and 25 mu g Fentanyl (vol 0.5 ml) in Group F (Fentanyl). The onset time to reach peak sensory and motor level, the regression time for sensory and motor block, hemodynamic changes and side-effects were noted. RESULTS: The duration of sensory and motor block, rescue analgesia was significantly prolonged in Dexmedetomidine group when compared to that of the Fentanyl group which is longer than that of Control group. CONCLUSION: Dexmedetomidine 5 mu g seems to be better than 25 mu g Fentanyl as a neuraxial adjuvant to hyperbaric Bupivacaine.