Journal of AdvancedMedical and Dental Sciences Research

Background: Pain relief during maternal labor is one of the main goals of maternity care. Combined spinal epidural analgesia is an accepted technique to alleviate labor pain with minimal side-effects to mother and fetus. Aims: To evaluate the effect of combination of intrathecal dexmedetomidine and fentanyl on maternal and neonatal outcomes during labor in comparison to dexmedetomidine or fentanyl alone. Materials and Methods: We carried out a prospective study on 120 consecutive parturients over a period of 1-year from June 2017 to December 2017 at a tertiary care hospital. Patients were randomly divided to three groups of 40 each: Group D (n=40): Patients received 5 ìg intrathecal dexmedetomidine in 1 ml of normal saline; Group F (n=40): Patients received IT 20 ìg fentanyl in 1 ml of normal saline and Group DF (n=40): Patients received IT 5 ìg dexmedetomidine plus 10 ìg fentanyl in 1 ml of normal saline. Maternal heart rate and non invasive blood pressure were recorded every 5 minutes following the intrathecal injection. Other side effects such as pruritus, nausea and vomiting and respiratory depression were recorded. Results: Demographic findings were comparable in all the groups. Onset of analgesia was faster and duration of analgesia was longer in group DF than in the two other groups. There was no statistical difference between the three groups as regard the mode of delivery. Regarding to maternal side-effects; hypotension and bradycardia were recorded in group D (6 patients (15%), 5 patients (12.5%) respectively) more than the two other groups; the fentanyl group showed significant increase in pruritus 10 patients (25%); lastly nausea and vomiting were detected only in DF group one patient (2.5%). Conclusion: Addition of 5 ìg intrathecal dexmedetomidine to 10 ìg fentanyl prolonged the duration of analgesia. The combination decreases the incidence of side effects in comparison to IT 10 ìg dexmedetomidine or IT 20 ìg fentanyl alone. Key words: Analgesia, Dexmedetomidine, Fentanyl, Labor, Neonatal