| Abstrakt: |
Background and Aim: In modern anaesthesia practice combining small doses of adjuvant like midazolam, clonidine, opioids specially fentanyl to local anesthetics intrathecally improve quality of intraoperative anaesthesia, prolong analgesia and decrease the complications associated with high dose of local anesthetics. Fentanyl provides improved quality of intraoperative and early postoperative subarachnoid block, increased duration of analgesia, but associated with respiratory depression, pruritus and retention of urine. Dexmedetomidine, a highly selective alpha-2 agonist provide stable hemodynamic condition, good quality of intraoperative anaesthesia, prolonged postoperative analgesia, potentiate the action of local anaesthetics with minimal side effects. The present study has been designed to compare the effects of adding dexmedetomidine 5 µgm and fentanyl 25 µgm to 0.5% Levobupivacaine on subarachnoid block characteristics, duration of sensory and motor block, postoperative analgesia and sedation. Methods: 90 patients of ASA I and II patients of age group 15-50 years posted for elective surgical procedure under spinal anaesthesia were divided into 3 groups of 30 each. Group A (n=30) received 15 mg of Levobupivacaine with 5 µgm dexmedetomidine, Group B (n=30) received 15 mg of Levo bupivacaine with 25 µgm fentanyl and Group C (n=30) received 15 mg of Levobupivacaine with normal saline intrathecally. Duration of surgery, duration of motor block, blood pressure, heart rate (HR) and oxygen saturation (Sp02) were monitored. Pain assessment was done by Visual Analogue Scale (VAS) till 24 hrs and level of sedation was assessed. Results: Intraoperative and postoperative sedation score were significantly different among the groups. The haemodynamic response following subarachnoid block was comparable among three groups. Overall side effects like nausea, vomiting, pruritus were significantly different among groups. [ABSTRACT FROM AUTHOR] |
