Comparision of dexmedetomidine and fentanyl as adjuvants to 0.5% hyperbaric bupivacaine in spinal anesthesia in elective lower abdominal surgeries

Abstract

Spinal anesthesia has become most commonly used and choice of anaesthesia for surgeries on lower half of body after first planned spinal anaesthesia for surgery in man was administered by August Bier (1861–1949) on 16 August 1898, in Kiel(1), Germany. Coadministration of adjuvant drugs improve the quality and duration of anesthesia and analgesia and patient safety. To compare effects of Dexmedetomidine and Fentanyl as adjuvants to 3ml of 0.5% heavy bupivacaine injected intrathecally, in lower abdominal surgeries. Prospective randomized comparative study. The study was approved by ethics committee and was conducted in 100 randomly selected patients posted for elective lower abdominal surgeries in the age group 18-60yrs belonging to both sex. Patients were divided into two groups- Group D (n=50) - received 5μg Dexmedetomidine+3ml 0.5% heavy bupivacaine, Group F(n=50)-received 25μg Fentanyl +3ml 0.5% heavy bupivacaine, intrathecally respectively.In groupD patients onset of sensory block was significantly faster 2.62±0.56 mins (p<0.001) with better haemodynamic stability, intraoperative sedation, less incidence of side effects and analgesic sparing effect in post operative period when compared to group F.αadrenergic agonist dexmedetomidine is a valuable adjunct to spinal anaesthesia it augments quality of spinal anaesthesia provides intraoperative sedation and hemodynamic stability.