&lt;p&gt;Comparative Study of Fentanyl vs Dexmedetomidine as Adjuvants to Intrathecal Bupivacaine in Cesarean Section: A Randomized, Double-Blind Clinical Trial&lt;/p&gt;

Khosravi, Fatemeh; Sharifi, Mehdi; Jarineshin, Hashem

doi:10.2147/jpr.s265161

Cited by 11 publications

(10 citation statements)

References 22 publications

(51 reference statements)

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“…Additionally, patients receiving dexmedetomidine had a faster onset of sensory action (1.54 ± 0.38 minutes) which was statistically significant. Our findings are consistent with those of Khosravi et al [ 8 ] and of Shukla et al [ 9 ] studies that also found a better onset time for 5 µg dexmedetomidine.…”

Section: Discussionsupporting

confidence: 94%

Addition of Dexmedetomidine and Fentanyl to Intrathecal Hyperbaric Bupivacaine for Lower Limb Surgeries: A Randomized, Comparative Study

Kalbande¹,

Deotale²,

Archana³

et al. 2022

Cureus

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Background and aim: There is an unmet need to prolong analgesia duration following regional anesthesia; dexmedetomidine as an adjuvant for the intrathecal block has gained popularity over the last few years. The present study compares the onset, duration of sensory and motor block, postoperative analgesia, hemodynamic changes, and adverse effect of dexmedetomidine or fentanyl as an adjuvant to hyperbaric bupivacaine administered intrathecally.Methods: With approvals, 60 American Society of Anesthesiologists (ASA) physical status I and II adult patients undergoing lower limb surgeries under subarachnoid block were randomized to receive either 5 µg dexmedetomidine (group BD, n=30) or 25 μg fentanyl (group BF, n=30) intrathecally along with 12.5 mg hyperbaric bupivacaine. The time to onset of sensory and motor blockade, time to peak block, intraoperative hemodynamic variations, duration of postoperative analgesia, and associated intraoperative and postoperative complications, if any, were recorded and compared statistically. SPSS v16 (IBM Corp., New York, United States) was used, and P<0.05 was considered significant.Results: The onset of sensory block in group BD was 1.54 ± 0.38 minutes and 3.4 ± 0.40 minutes (P<0.001) in group BF. Time taken for the sensory level to reach T10 in group BD was 3.11± 0.43 minutes and 5.55 ± 0.60 minutes (P<0.001) in group BF. Time taken for two-segment regression in group BD was 160.06 ± 6.85 minutes and 110.4 ± 6.03 minutes (P<0.001) in group BF. The onset of motor block was 2.58 ± 0.437 minutes in group BD and 4.43 ± 0.43 minutes (P<0.001) in group BF. The total duration of analgesia in group BD was 365.8 ± 24.76 minutes and 213.33 ± 20.19 minutes (P<0.001) in group BF. Minimum intraoperative hemodynamic variations were found in group BD, and two groups had comparable side effects. Conclusion: Dexmedetomidine 5 μg added to intrathecal bupivacaine produced early-onset and prolonged block compared with fentanyl 25 μg. No significant attributable adverse effects were noted for both the drugs except the fall in blood pressure, which was gradual in dexmedetomidine but a steep fall in fentanyl.

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Section: Discussionsupporting

confidence: 94%

Addition of Dexmedetomidine and Fentanyl to Intrathecal Hyperbaric Bupivacaine for Lower Limb Surgeries: A Randomized, Comparative Study

Kalbande¹,

Deotale²,

Archana³

et al. 2022

Cureus

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“…Many studies showed that adding Dex to local anesthetics enhanced the effectiveness of central and peripheral nerve blocks. Dex has been reported to significantly extend the analgesia time when used as an adjuvant in epidural block, 20 PVB, 13,21 subarachnoid block, 22 and brachial plexus block analgesia. 23 A systematic review of 12 RCTs found that epidural Dex was associated with prolonged duration of analgesia, short onset of sensory block, decreased need for rescue analgesia, and higher sedation scores compared to control treatment.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of dexmedetomidine as an adjuvant in erector spinae plane block in breast cancer surgery: a randomized controlled trial

Hassan¹,

Abdelgalil²

2023

Anaesth. pain intensive care

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Background: The erector spinae plane block (ESPB) is a new potential inter-fascial block technique used to decrease pain after breast surgery. Dexmedetomidine (Dex) is used as an adjuvant to local anesthetics and is thought to improve the analgesic profile and duration of different anesthetic techniques. We evaluated the effect of adding Dex in local anesthetic solution for ESPB in breast cancer surgeries regarding the analgesic effect and duration. Methodology: This prospective randomized controlled study included 60 female patients scheduled for breast cancer surgery. All patients were anesthetized in a standard manner, and then were randomized into three equal groups; 1. ESP group, to receive an ultrasound-guided ESPB with 20 ml bupivacaine 0.5%; 2. Dex group, to receive ESPB with 19 ml bupivacaine 0.5% and 1 ml of normal saline containing 1 µg/kg Dex, and the control group received the standard general anesthesia only. The intraoperative fentanyl and postoperative morphine consumption were noted. Postoperative pain was assessed on numerical pain rating scale (NRS) Results: The duration of analgesia was significantly prolonged in ESPB and Dex groups than in the control group and in the Dex group than in ESPB group (P < 0.001). Intraoperative fentanyl and postoperative morphine consumption were significantly lower in ESPB and Dex groups than in the control group. NRS pain scores were comparable in the three groups during the first 24 h. Conclusions: Adding dexmedetomidine 1 µg/kg to bupivacaine 0.5% prolongs the duration of analgesia of the ESPB in breast cancer surgeries. Key words: Analgesia; Breast Cancer; Breast Surgery; Bupivacaine; Dexmedetomidine; Nerve Block Citation: Hassan ME, Abdelgalil AS. Efficacy of dexmedetomidine as an adjuvant in erector spinae plane block in breast cancer surgery: a randomized controlled trial. Anaesth. pain intensive care 2022;27(1):16−22; DOI: 10.35975/apic.v27i1.2109 Received August 16, 2022; Reviewed: November 13, 2022; Accepted: December 03, 2022

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“…The reason for a prolonged duration of analgesic effect after TAP blockade may relate to the fact that the TAP is relatively poorly vascularized, and therefore drug clearance may be delayed. Biswas et al [ 26 ] and Khosravi et al [ 27 ] compared the analgesic efficacy of intrathecal fentanyl with hyperbaric bupivacaine after caesarean delivery, showed no significant differences in neonatal Apgar scores at 1 min and 5 min. In our study, also there were no differences in neonatal Apgar scores at 1 min and 5 min.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of the analgesic efficacy of intrathecal fentanyl with ultrasound-guided transversus abdominis plane block after lower segment cesarean section

et al. 2021

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Background: This study was conducted to compare the analgesic efficacy of intrathecal fentanyl with ultrasound-guided transversus abdominis plane (TAP) block after lower segment cesarean section. The objectives of the study were to compare the effects of subarachnoid fentanyl versus TAP block with respect to duration of postoperative analgesia, time for first analgesic request, total analgesic consumption in 24 h, time to first breastfeed and Apgar score at 1 and 5 min. Materials and Methods: Sixty-two patients undergoing elective or emergency cesarean delivery were recruited for the study in a prospective, randomized, single-blind manner. The patients were randomly allocated to either intrathecal fentanyl group (Group F) or TAP block group (Group T) after determining the eligibility criteria. Group F patients received subarachnoid block with 10 mg of 0.5% bupivacaine heavy with 25 mcg of fentanyl. Group T patients received subarachnoid block with 10 mg of 0.5% bupivacaine heavy prior to surgery and at the end of surgery, they received TAP block with 0.25% bupivacaine 20 mL on each side. Results: Group T had significantly longer time for the first analgesic request (7.65 ± 1.23 h) than group F (4.10 ± 0.32 h). The total analgesic consumption in 24 h was significantly less in Group T (1.0 ± 0) than Group F (2.13 ± 0.34). The Visual Analogue Scale scores at rest and on movement were significantly less in Group T than Group F at all-time points. The Apgar score at 1 and 5 min and time to first breast feed were comparable between the two groups. The incidence of side effects was less in Group T. Conclusion: This study indicated that ultrasound-guided TAP block has a better analgesic as well as safety profile compared to intrathecal fentanyl for cesarean delivery.

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<p>Comparative Study of Fentanyl vs Dexmedetomidine as Adjuvants to Intrathecal Bupivacaine in Cesarean Section: A Randomized, Double-Blind Clinical Trial</p>

Cited by 11 publications

References 22 publications

Addition of Dexmedetomidine and Fentanyl to Intrathecal Hyperbaric Bupivacaine for Lower Limb Surgeries: A Randomized, Comparative Study

Addition of Dexmedetomidine and Fentanyl to Intrathecal Hyperbaric Bupivacaine for Lower Limb Surgeries: A Randomized, Comparative Study

Efficacy of dexmedetomidine as an adjuvant in erector spinae plane block in breast cancer surgery: a randomized controlled trial

Comparative study of the analgesic efficacy of intrathecal fentanyl with ultrasound-guided transversus abdominis plane block after lower segment cesarean section

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