Comparative Study of Effect of Dexmedetomidine and Fentanyl as Epidural Adjuvants in Abdominal Hysterectomies Using Combined Spinal Epidural Technique - A Randomised Prospective Study

Abstract

Background: Regional anesthesia is defined as loss of sensation in a body produced by administration of anaesthetic agent to the nerves supplying that region. Regional anesthesia whether by spinal, epidural, peripheral nerve blocks offer a number of advantages. Bupivacaine has become standard agent for intrathecal anesthesia. A number of adjuvants can be added to prolong the duration of analgesia. In our study we are comparing fentanyl & dexamedetomidine as an epidural adjuvant to spinal bupivacaine in abdominal hysterectomies. Materials and Methods: A total of 60 patients scheduled for abdominal hysterectomy under CSE were enrolled for this prospective randomized study which was conducted in hospital from November 2019 to October 2020. This work has been granted ethical committee approval. Results: Two groups comprising of 30 patients each were taken randomly. Haemodynamic parameters of heart rate, blood pressure, spo2, were monitored and recorded every 5 min for first 20 minutes and then every 10 minutes till the end of surgery and thereafter postoperatively. The sensory block was assessed by bilateral pin prick method and motor blockade according to Modified Bromage Scale. Duration of anesthesia was taken as time period till VAS of 4 was recorded. Conclusion: In our study we concluded that dexmedetomidine is better adjuvant as compared to fentanyl in combined spinal epidural anaesthesia with intrathecal bupivacaine.