Comparison between the Effect of Fentanyl and Dexmedetomidine in Different Doses Intrathecally Adjuvant to Bupivacaine for Lower Abdominal Surgeries

Abstract

Background: Spinal anaesthesia has many advantages, such as quick action and a reduced recovery time in the postanesthesia care unit, which makes it a reliable and safe choice for surgeries involving the lower legs and abdomen.
Objective: This research aimed to evaluate the effects of intrathecal hyperbaric bupivacaine given in three different doses, namely 5 μg, 10 μg, and 15 μg, both on its own and in conjunction with either fentanyl or dexmedetomidine.
Methods: This prospective, double-blind, randomised trial involved 200 patients, comprising both males and females aged between 21 and 50, who were having scheduled lower abdominal surgery with spinal anaesthesia. Each of the five groups of patients was given an intrathecal injection of a mix that consisted of 15 mg bupivacaine at 0. 5% concentration and a total volume of 3. 5 ml, which contained 0. 5 ml of normal saline. An extra 0. 5 ml of normal saline was provided to Group I, while Group II got 0. 5 ml that included 25μg fentanyl, Group III was administered 0.5ml with 5μg dexmedetomidine, Group IV received 0.5ml with 10μg dexmedetomidine, and Group V received 0.5ml with 15μg dexmedetomidine.
Results: Groups D1, D2, and D3 required significantly more time to provide initial rescue analgesia than groups C and F. At 10 minutes, group D3's heart rate was noticeably lower than that of groups C, F, D1, and D2. Groups D1, D2, and D3 had considerably lower mean arterial pressures than group C. Compared to groups C, F, D2, and D2, group D3 had considerably greater levels of hypotension, bradycardia, and patient satisfaction.
Conclusions: The results show that Dexmedetomidine and Fentanyl helped maintain stable breathing, making them useful additions to spinal anesthesia.