Comparison of Levobupivacaine and Levobupivacaine with Dexmedetomidine in Infraumbilical Surgeries under Spinal Anaesthesia

Background: Spinal anesthesia is a popular choice for infraumbilical surgeries due to its effectiveness and minimal systemic effects. Levobupivacaine, a long-acting local anesthetic with lower cardiotoxicity than bupivacaine, is commonly used. Combining it with adjuvants like dexmedetomidine, an alpha-2 adrenergic agonist, may enhance analgesia and prolong the effects of anesthesia. Methods: This randomized double-blind study involved 120 patients undergoing elective infraumbilical surgeries. Participants were divided into two groups: Group L received 0.5% levobupivacaine, and Group LD received levobupivacaine with dexmedetomidine. Outcomes such as onset and duration of sensory and motor blocks, hemodynamic stability, and postoperative analgesia were assessed. Results: The onset of sensory block was significantly faster in Group LD compared to Group L, with times of 5.40 ± 0.79 minutes versus 6.80 ± 1.37 minutes, respectively (P < 0.001). Similarly, the duration of the sensory block was markedly longer in Group LD, lasting 306.18 ± 10.60 minutes compared to 179.55 ± 7.16 minutes in Group L (P < 0.001). For motor block onset, Group LD experienced a quicker onset at 7.02 ± 1.19 minutes, compared to 13.10 ± 2.12 minutes in Group L (P < 0.001). The duration of the motor block was also prolonged in Group LD, with a duration of 199.22 ± 9.76 minutes, compared to 145.75 ± 8.25 minutes in Group L (P < 0.001). Conclusion: The addition of dexmedetomidine to levobupivacaine for spinal anesthesia improves the onset and duration of anesthesia and provides better postoperative analgesia compared to levobupivacaine alone. This combination may enhance patient outcomes in infraumbilical surgeries.