Comparative Study of Intrathecal Fentanyl and Dexmedetomidine as Adjuvants to 0.5% Hyperbaric Bupivacaine for Lower Limb Orthopaedic Surgeries.

BACKGROUND Spinal anaesthesia is the most common procedure for lower limb orthopaedic surgeries. Fentanyl, a synthetic opioid and dexmedetomidine, a selective α2 agonist have been used in this study as adjuvants to 0.5% hyperbaric bupivacaine for spinal anaesthesia in lower limb orthopaedic surgeries. AIM The main aim of the study is to compare the efficacy, analgesic effects, hemodynamic stability and side effects of intrathecal fentanyl and dexmedetomidine as adjuvants to 0.5% hyperbaric bupivacaine in lower limb orthopaedic surgeries. MATERIALS AND METHODS 100 patients of ASA class 1 and 2 posted for lower limb orthopaedic surgeries were taken for this study. Patients were randomly allocated using sealed envelopes into 2 groups. Group F - 17.5mg of 0.5% hyperbaric bupivacaine with 25mcg fentanyl intrathecally and group D - 17.5mg of 0.5% hyperbaric bupivacaine with 10 mcg of dexmedetomidine intrathecally. RESULTS In patients who have received dexmedetomidine observed to have significantly longer analgesic effects than the other group who received fentanyl as adjuvant. Mean duration of sensory blockade for group D was 455.54 ± 43.09 mins when compared to Group F which was 283.32 ± 23.994 mins. Post operative shivering was more in Group F patients when compared to Group D patients. CONCLUSION Using dexmedetomidine as an adjuvant to hyperbaric bupivacaine for spinal anaesthesia in lower limb orthopaedic surgeries has longer duration of sensory and motor block and longer postoperative analgesia when compared to intrathecal fentanyl. [ABSTRACT FROM AUTHOR]