Comparative Study of Dexmedetomidine vs Fentanyl as Adjuvant to Intrathecal Bupivacaine in Infraumblical Surgeries

Background: Spinal anaesthesia is widely used for infraumbilical and gynaecological surgeries, further the addition of intrathecal adjuvants improve the quality, duration of anaesthesia and analgesia. This prospective randomised controlled study was conducted to compare the efficacy and adverse effects of intrathecal dexmedetomidine and fentanyl as adjuvants to hyperbaric bupivacaine. Aim: To compare the efficacy and adverse effects of intrathecal dexmedetomidine and fentanyl as adjuvants to hyperbaric bupivacaine in patients undergoing infraumbilical surgeries. Materials and Methods: This prospective randomized controlled study included 60 patients scheduled for elective infraumbilical surgeries under spinal anaesthesia. Patients were randomly allocated into two groups. Group BD received 0.5% hyperbaric bupivacaine (13 mg) with dexmedetomidine 5 µg, while Group BF received 0.5% hyperbaric bupivacaine (13 mg) with fentanyl 25 µg intrathecally. The onset and duration of sensory and motor block, duration of postoperative analgesia, haemodynamic parameters, and adverse effects were evaluated. Results: The onset of sensory and motor block was comparable between the two groups. The duration of sensory block, motor block, and postoperative analgesia was significantly prolonged in the dexmedetomidine group compared to the fentanyl group (p < 0.05). Haemodynamic parameters remained stable in both groups. A higher incidence of hypotension and bradycardia was observed in the dexmedetomidine group, whereas pruritus and nausea were more common in the fentanyl group. No serious adverse effects were noted. Conclusion: Intrathecal dexmedetomidine is a safe and effective adjuvant to hyperbaric bupivacaine and provides significantly prolonged anaesthesia and postoperative analgesia compared to fentanyl. It may serve as a suitable alternative to intrathecal opioids for infraumbilical surgeries.