Journal of AdvancedMedical and Dental Sciences Research

Background: Spinal anaesthesia is most popular anaesthetic technique for surgeries involving lower part of body. Most common drug used is hyperbaric bupivacaine 0.5%. Various adjuvants are being used to potentiate the effect of analgesia and prolong the anaesthetic effect. Most common drug used as adjuvant is fentanyl. Dexmedetomidine is relatively newer adjuvant, which is being evaluated and compared with fentanyl in this study for its potency and efficacy. Aim: The aim of our study was to test and compare the efficacy of Dexmedetomidine with Fentanyl as adjuvant to hyperbaric Bupivacaine in spinal anaesthesia in lower limb surgeries. Settings and design: Prospective randomized double blind study in the setting of a tertiary care hospital. Material & Methods: Total 60 patients were enrolled in the study and were randomized and divided into two groups on the basis of adjuvants, group D (Dexmedetomidine 5 mcg), group F (Fentanyl 20 mcg) with hyperbaric Bupivacaine 0.5%. After giving neuraxial block, effect of drugs were evaluated noting time, frequency and dose of rescue analgesia, modified Bromage scale, sensory level and duration of block and other hemodynamic parameters. Side effects like nausea, vomiting, pruritis, bradycardia, hypotension were also noted. Results: All demographic parameters were comparable in all groups. Time to rescue analgesia were statistically significant, showing longer sensory block and more effective analgesia in group D. Similar results were found for motor block ascertained by modified Bromage score. Evidence of significant bradycardia was noted in group D intraoperatively. Other parameters were comparable among all groups. Conclusion: Dexmedetomidine as adjuvant to hyperbaric bupivacaine in neuraxial blockade prolongs analgesic effect as well as motor block more than Fentanyl. There were no significant side effects noted except bradycardia in Dexmedetomidine group. Keywords: Dexmedetomidine, Spinal Adjuvant, Fentanyl