Comparative study between fentanyl versus dexmedetomidine as adjuvant to intrathecal bupivacaine in lower abdominal surgeries

Background and aim Intrathecal fentanyl mediates its effects via binding to opioid receptors within the spinal cord’s dorsal horn. Additionally, it could show a supraspinal distribution as well as action. We aimed to compare the effects of the addition of dexmedetomidine versus fentanyl to intrathecally injected hyperbaric bupivacaine while performing elective lower abdominal surgical procedures. Patients and methods We designed a prospective randomized controlled, double-blind study, including 150 cases admitted for elective lower abdominal surgical procedures. Participants underwent an equal categorization into three groups: all had intrathecally 3 ml volumes of 0.5% hyperbaric bupivacaine, along with 5 µg dexmedetomidine in 0.5 ml of normal saline within group D, 25 µg fentanyl (0.5 ml) within group F, while in addition to normal saline (0.5 ml) within group C. Results The analgesic duration exhibited a significant reduction within group C in comparison to group F as well as D. The motor block onset exhibited significantly higher values within group C in comparison to group F as well as D. Duration of motor block exhibited a significant reduction within group C as opposed to group F and D. Sedation score showed a significant reduction within group C in comparison to group F as well as D. Mean arterial pressure at 6 h postoperative, a significant reduction was documented within group C compared to group F as well as D. Conclusion Combined administration of intrathecal dexmedetomidine with hyperbaric bupivacaine for elective lower abdomen procedures resulted in a rapid and extended sensory and motor block.