A Comparative Study of Effects of Adding Dexmedetomidine and Fentanyl as an Adjuvant to Isobaric Levobupivacaine in Lower Segment Cesarean Section: A Prospective Randomized Double-Blind Clinical Study

Background: Intrathecal Bupivacaine is the most often used local anaesthetic for lower segment caesarean sections, but researchers are always exploring for new local anaesthetics with better safety profiles for both the mother and the foetus. Many adjuvants, such as fentanyl, morphine, or tramadol, have been used with intrathecal local anaesthetics in the past to prolong intraoperative anaesthesia and postoperative analgesia. There is no literature on the use of dexmedetomidine as an adjuvant with isobaric levobupivacaine. As a result, we wanted to see how dexmedetomidine and fentanyl performed in lower segment caesarean sections when paired with 0.5 percent isobaric intrathecal levobupivacaine in spinal anaesthesia.

Methodology: Following clearance by the institutional ethical committee and informed written agreement, patients were divided into three equal groups: Group L will get 2.5 ml of 0.5 percent isobaric levobupivacaine, 5 g dexmedetomidine, and 25 g fentanyl intrathecally; Group LD will receive 2.5 ml of 0.5 percent isobaric levobupivacaine and 5 g dexmedetomidine intrathecally; and Group LF will receive 2.5 ml of 0.5 percent isobaric levobupivac The primary goal was the length of sensory and motor blockage from the time medications were administered intrathecally. For statistical analysis, the chi-square test or Fischer’s exact test, as well as One-way ANOVA or the Kruskal Wallis test, were utilised. A P value of less than 0.05 was used to determine statistical significance.

The sensory and motor blockage lasted significantly longer in the LD group (P0.001) than in the LF or L groups. Sensory and motor blockage occurred earlier in the LF group than in the LD and L groups (P 0.001). The LD group took longer than the LF and L groups to reach initial rescue analgesia (P 0.001).

Conclusion: Intrathecal dexmedetomidine produced longer blockade and postoperative analgesia than fentanyl when used as an adjuvant to 0.5 percent isobaric levobupivacaine in elective caesarean section.

Author (S) Details

Alok Kumar Bharti
Department of Anaesthesiology and Critical Care Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.

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