Effect of Intrathecal Dexamethasone Versus Dexmedetomidine as an Adjuvant to Hyperbaric Bupivacaine on Sensory Block and Postoperative Analgesia in Elective Ceserean Section

Background: Spinal anesthesia is typically used for caesarean sections. For a brief duration, it effectively manages postoperative pain. This study aimed to improving the quality of anesthesia and postoperative pain by adding intrathecal dexamethasone or dexmedetomidine as adjuvants to hyperbaric bupivacaine in elective Cesarean section. Methods: This prospective randomized controlled double blind clinical study, included Forty Eight parturients prepared for cesarean section were divided into three groups, each of 16 parturients. Group C who received 1ml saline added to 10mg hyperbaric bupivacaine. Group D who received 4mg of dexamethasone (1 ml) added to 10mg hyperbaric bupivacaine. Group M who received 10mcg of dexmedetomidine diluted in 1ml saline added to 10mg hyperbaric bupivacaine. Results: There was a significant difference between the studied groups regarding the visual analog scale at 6,12,18 and 24 hours, as group M had a lower VAS scale when compared with the other two groups. The onset of sensory block, groups D and M demonstrated significantly accelerated sensory block onset compared to group C, group M exhibited the most prolonged sensory block duration with the mean of (310±21.01) minutes, surpassing both group D and group C. Group D consumed substantially less nalbuphine overall than group C, with a mean of 22.19±3.64 compared to group C mean of 29.38±6.29. Group M had a mean of 7.81±3.15 which was significantly lower than both group C and group D. Conclusion: Dexmedetomidine provides significantly longer postoperative analgesia with less analgesics requirement during the first 24 hours post operatively compared to dexamethasone.