A Comparative Study between Intrathecal Dexmedetomidine and Fentanyl as Additives to Bupivacaine in Pott’s Fracture Surgery

Document Type : Original Article

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Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Egypt.

Abstract

Background: recently, the popularity of adjuvants in intrathecal anesthesia has grown. Reports suggest that incorporating opioids and other medications can enhance the quality of spinal anesthesia. However, to date, no single drug is completely free of side effects. This study aimed to compare the effects of adding either dexmedetomidine or fentanyl to intrathecal bupivacaine in Pott’s fracture. Focusing on differences in the onset and duration of sensory and motor block, hemodynamic impacts, postoperative pain relief, and the adverse effects associated with each drug.

Result: Patients in the dexmedetomidine group (D) experienced quicker onset of both sensory and motor blocks compared to those in the fentanyl group (F) and the bupivacaine group (B). Patients in group D experienced notably longer sensory and motor block durations compared to those in groups F and B. Patients in the dexmedetomidine group (D) exhibited minimal hemodynamic changes, experienced extended analgesia with reduced need for additional analgesics over 24 hours and had minimal adverse effects.

Conclusion: When administered intrathecally with bupivacaine, dexmedetomidine has a quicker onset than fentanyl and bupivacaine alone. It also extends the duration of sensory and motor blocks, maintains hemodynamic stability, results in minimal side effects, and reduces the need for postoperative analgesics in the first 24 hours.

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