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Comparison of Effects of Intrathecal Fentanyl versus Dexmedetomidine in Patients undergoing Transurethral Resection of Prostate

Jalakandan B., Associate Professor, Department of Anaesthesiology, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry 605502, India. (Affiliated to Bharath University, Chennai, Tamilnadu, India). , Jalakandan B.1 , Srinivasan S.M.2

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Indian Journal of Anesthesia and Analgesia 5(10):p 1646-1653, Oct 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51018.10

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Abstract

Objectives: Comparison of block characteristics and postoperative analgesic efficacy of Fentanyl and Dexmedetomidine, as a adjuvant to intrathecal hyperbaric 0.5% Bupivacaine for patients undergoing Transurethral resection of Prostate(TURP). Methods: 100 patients belonging to ASA physical status I & II were divided into two groups of 50 each. Group F (Fentanyl group) received
2ml Inj. Bupivacaine heavy with 25µg of Fentanyl. Group D (Dexmedetomidine group) received 2ml Inj. Bupivacaine heavy with 5µg of Dexmedetomidine. The time of onset of sensory and motor block, haemodynamic status, duration of motor blockade and postoperative analgesia and adverse effects, if any were compared in both the groups. Results: Time from injection to highest sensory level and Onset of Bromage 3 was similar in both groups. The time taken to reach the level of T10 after injection was significantly less and the time taken to regression to Bromage 0 was significantly more in group D compared to group F (p<0.001). Intraoperatively both groups remained haemodynamically stable. Incidence of bradycardia was more in Group D and incidence
of pruritus was more in Group F, though it was not statistically significant (p=0.402). Intraoperative sedation was higher in Group D (p<0.001) and postoperatively Visual analogue scores were significantly lower with group D (p<0.001). Conclusion: Dexmedetomidine appears to be an attractive adjuvant to intrathecal Bupivacaine than Fentanyl as there is significantly longer duration of motor block. It provides good quality of intraoperative analgesia, haemodynamically stable conditions, minimal side effects, and excellent quality of postoperative analgesia.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51018.10

Keywords

Intrathecal; Bupivacaine; Fentanyl; Dexmedetomidine; Bromage; Postoperative Analgesia; Transurethral Resection of Prostate

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