Study on Addition of Dexmedetomidine Versus Fentanyl to Intrathecal Hyperbaric Bupivacaine for General and Orthopedic Surgeries

Background: Spinal anaesthesia is extensively used for overall and orthopaedic surgeries due to its effective sensory and motor blockade.Hyperbaric oxygen therapy bupivacaine is a generally used local anaesthetic, and the addition of adjuvants like dexmedetomidine and fentanyl can improve its effects.This study compares these two adjuvants' efficacy in terms of analgesia duration, motor block, hemodynamic stability, and postoperative complications.Methods: A randomized observational study was conducted on 104 patients experiencing lower abdominal and orthopaedic surgeries.Patients were separated into two groups: Group A (dexmedetomidine, five mcg) and Group B (fentanyl, 25 mcg), with 52 patients each.Both groups received intrathecal hyperbaric bupivacaine (0.5%).The duration of analgesia, motor block, hemodynamic parameters, and postoperative complications were recognized and analyzed significantly. Results:The results of this study showed that Dexmedetomidine provided longer analgesia and motor block than fentanyl (p<0.001),though fentanyl showed lower pain scores postoperatively (p<0.05).Surgical durations were similar.Bradycardia was more common with dexmedetomidine; hypotension, itching, and dry mouth occurred more with fentanyl.Nausea and vomiting were slightly more frequent with dexmedetomidine; chills were comparable. Conclusion:This study has concluded that the SCFP group has significantly higher coronary flow values compared to the Control group across the LAD (Left Anterior Descending artery), LCX (Left Circumflex artery), and RCA (Right Coronary Artery).