DEXMEDETOMIDINE VERSUS FENTANYL WITH INTRATHECAL BUPIVACAINE FOR POSTOPERATIVE ANALGESIA IN UROLOGICAL PROCEDURES: A DOUBLE BLIND COMPARITIVE STUDY.

Seventy six patients of American Society of Anaesthesiologists status I and II scheduled for urological procedures were studied to evaluate the onset and duration of Sensory and motor block, postoperative analgesia and adverse effects of Dexmedetomidine and Fentanyl given intrathecally with hyperbaric 0.5% Bupivacaine. Material And Methods: Patients were randomly allocated into two groups. Group I received 12.5 mg 0.5% Bupivacaine + 25 μg Fentanyl. And Group II received 12.5 mg 0.5% Bupivacaine + 5 μg Dexmedetomidine (vol-3ml). The onset, time to reach peak sensory and motor level, the regression time for Sensory and motor block, postoperative analgesia and side effects were recorded. Results: The onset time to reach peak sensory level as well as onset time to reach modified Bromage 3 motor block were insignificant in both the groups. The mean time of sensory regression to S1 in Group I was 276.21 ? 52.23 mins and in Group II was 417.34 ? 38.66 mins (p<0.05)). The regression time of motor block to reach modified Bromage 0 in Group I was 168.28 ? 29.84 mins and in Group II was 267.15 ? 34.40 mins (p<0.05)). The time for rescue analgesic i.e. post-op analgesia in Group I was 320.57 ? 33.00 mins and in Group II it was found to be 423.68 ? 37.58 mins (p<0.05)). The hemodynamics, sedation scores and side effects were not significantly different in both groups except for bradycardia noted with Dexmedetomidine. Conclusion: 5 μg Dexmedetomidine provides better hemodynamic stability, minimal side effects, and excellent quality of postoperative analgesia as an adjuvant to spinal Bupivacaine in urological procedures.