IS DEXMEDETOMIDINE A SUPERIOR ADJUVANT FOR SEGMENTAL SPINAL ANAESTHESIA TO AID EARLY AMBULATION WITHOUT PAIN?

Spinal anaesthesia is the most used technique for lower abdominal surgeries as it is very economical and easy to administer. However, postoperative pain control is a major problem because spinal anaesthesia using only local anaesthetics is associated with a relatively short duration of action, and thus early analgesic intervention is needed in the postoperative period. The objective of the study is to estimate the perioperative analgesic effects of dexmedetomidine and fentanyl as an adjuvant for thoracic segmental spinal anaesthesia while aiding early ambulation and to evaluate the hemodynamic stability offered by thoracic segmental spinal anaesthesia with its adjuvant for lower abdominal surgeries. In this study 25G Quincke spinal needles were inserted through T9-T10 interspace in a sitting position using aseptic precautions to deliver the drug into intrathecal space. In this study, the mean time for onset of sensory block was significantly shorter with both dexmedetomidine and fentanyl compared to plain ropivacaine. Furthermore, the onset of sensory block was faster with the addition of dexmedetomidine to ropivacaine compared to the addition of fentanyl. Furthermore, the time to rescue analgesia was longer, and the number of top-ups needed in 24 h was lesser with the addition of dexmedetomidine, compared to the addition of fentanyl. It can therefore be concluded that both dexmedetomidine and fentanyl enhance readiness for surgery. Dexmedetomidine produced a more prolonged duration of sensory block and postoperative analgesia as compared to fentanyl, which is highly significant compared to ropivacaine. Dexmedetomidine has been shown to have an upper edge over fentanyl when used as an adjuvant to ropivacaine for thoracic segment spinal anesthesia.