Comparison of Dexmedetomidine and Fentanyl as Adjuvants to Intrathecal Levobupivacaine in Lower Segment Cesarean Section

Abstract

Objective: To determine the effectiveness of dexmedetomidine on the spinal anaesthesia as an adjuvant to the hyperbaric levobupivacaine in patients undergoing cesarean section. Study Design: Comparative/Observational Place & Duration: The study was conducted at Anesthesiology/Obstetrics and Gynaecology departments of Mayo hospital, Lahore for duration of six months i.e from 1st November 2020 to 30th April 2021. Methods: This analysis included a total of 120 cases. After the informed consent the patients had received comprehensive demographics. Three equal classes of patients were divided into groups A, B and C. Group I had 40 patients and received 2.5 ml isobaric levobupivacane, group II with 40 patients and received 2.5 ml isobaric levobupivacaine and 5μg dexmedetomidine, and group III received 2.5 ml isobaric levobupivacaine and 25 μg fentanyl intrathecally. The outcomes of these groups were analysed in which sensory and motor blockage period were measured from the time the intrathecal drugs were administered. The full SPSS 26.0 version was used to analyze the results. Results: The mean age of the patients in group I was 27.44 ± 7.64 years with BMI 23.19±8.44, mean age in group II was 27.22 ±7.42 years with BMI 24.44 ± 6.16 and in group III mean age was 26.99 ±9.61 years with BMI 24.72 ±4.34. Duration of sensory and motor blockade was observed and resulted that it was earlier in group III as compared to group I and II. Prolonged duration of sensory and motor blockade was observed in group II as compared to groups I and III with significantly P value< 0.001. Conclusion: We concluded that for an adjuvant of 0.5 percent isobaric levobupivalacaine, Intrathecal dexmedetomidine induces both prolonged motor blockage and post operative analgesia than fentanyl. Key words: Levobupivacaine; Spinal anesthesia, Fentanyl, Intrathecal analgesia, Cesarean section; Dexmedetomidine.