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Indian Journal of Anesthesia and Analgesia

Volume  5, Issue 9, September 2018, Pages 1557-1563
 

Original Article

Clinical Evaluation of Adding Fentanyl versus Dexmedetomidine to Intrathecal Isobaric Levobupivacaine on Spinal Block Characteristics in Patients Scheduled for Lower Abdominal Surgeries

Threja Chintamani Krishnappa1, Ravi Madhusudhana2, Dinesh Krishnamurthy3, Nikila Devarayasamudram Gopal4

1Assistant Professor 2Professor 3Professor & Head 4Senior Resident, Dept. of Anaesthesiology, Sri Devaraj Urs Medical College, RL Jalappa Hospital, SDUAHER, Tamaka, Kolar, Karnataka 563101, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5918.21

Abstract

Background: Fentanyl, an opioid and dexmedetomidine, an alpha 2 agonist added to local anaesthetics in spinal anaesthesia potentiates local anaesthetics action, have analgesic properties and reduces the requirement of local anaesthetics.

Aim: To evaluate the effect of adding fentanyl and dexmedetomidine to intrathecal isobaric levobupivacaine.

Materials and Methods: 60 patients scheduled for lower abdominal surgeries at our institute belonging to ASAgrade I-II satisfying inclusion criteria were recruited for the study and randomised to receive levobupivacaine 15mg with dexmedetomidine 5µg in group LD or levobupivacaine 15mg with fentanyl 25 µg in group LF. Sensory and motor block characteristics, haemodynamic changes and side effects were recorded.

Results: Onset of sensory block was shorter, time taken to attain maximum sensory block was shorter in group LD as compared to group LF with no stastistical significance. Maximum sensory block achieved was T4 in both the groups. Onset of motor blockade was faster and time taken to attain maximum bromage score 3 was faster in group LD as compared to group LF. Two segment regression duration, duration of analgesia, duration of sensory blockade and motor blockade were stastistically significantly prolonged in group LD as compared to groupLF. Patients maintained haemodynamic stability. Sedation scoring and side effects were insignificant. Data was analysed using Chi-square test and Independent t test.

Conclusion: Dexmedetomidine as an adjuvant to isobaric levobupivacaine for spinal anaesthesia fastens sensory, motor onset and enhances the block duration without any significant side effects as compared to fentanyl.

 


Keywords : Isobaric Levobupivacaine; Dexmedetomidine; Fentanyl; Spinal Anaesthesia.
Corresponding Author : Ravi Madhusudhana, Professor, Dept. of Anaesthesiology, Sri Devaraj Urs Medical College, RL Jalappa Hospital, SDUAHER, Tamaka, Kolar, Karnataka 563101, India.