Comparative Evaluation of Intrathecal Bupivacaine Alone, Bupivacaine-fentanyl, and Bupivacaine-dexmedetomidine in Caesarean Section

Abstract

Purpose: In this study, we aimed to compare the effects of bupivacaine alone, bupivacaine plus fentanyl, and bupivacaine plus dexmedetomidine for postoperative analgesia in women undergoing cesarean section under spinal anesthesia.

Material and methods: 90 term parturients scheduled to have elective cesarean section and ASA physical status I or II were allocated randomly into 3 groups to receive either bupivacaine (Bv group) or bupivacaine plus fentanyl (BvF group) or bupivacaine plus dexmedetomidine (BvD group). The onset time of sensory block, maximum sensory block level, duration of motor and sensory block, onset of post-operative pain, sedation scores, Apgar scores and side effects were recorded and statistically compared across 3 groups.

Results: Regression time to T10 was significantly longer in BvD group, sensory block was also prolonged in BvD group without any difference in duration of motor block. Onset of post-operative pain was delayed in BvD group. Sedation scores (VAS) were improved in case of BvD with least values of 0–3 followed by BvF (1–4). There was no significant difference in Apgar scores and neonatal arterial gas pressures across 3 groups.

Conclusion: The use of dexmedtomidine as an adjuvant to bupivacaine in cesarean surgeries provides better intra-operative and post-operative analgesia without having significant impact on Apgar scores or incidence of side effects.

Key words

bupivacaine - fentanyl - dexmedetomidine - post-operative analgesia - cesarean section - sensory block - motor block

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