Dexmedetomidine Or Fentanyl as An Adjuvant to Single Low-Dose Bupivacaine Intrathecal Anesthesia for Management of Normal Labor Pain, A Randomized Control Study

Document Type : Original Article

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Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: To improve the quality of the analgesia, adjuvants were added to intrathecal bupivacaine. The purpose of this work was to assess the efficacy of intrathecal dexmedetomidine [DEX] and fentanyl in reducing pain during delivery, patient satisfaction, and mother's outcome.
Methods: This randomized, controlled double-blind trial had been conducted on 90 women planned for spontaneous vaginal delivery. Participants were randomized into three groups equally and obtained intrathecal block by using 3.75 mg bupivacaine in 3 ml saline in the control group, plus 20 μg fentanyl in 3 ml saline in the fentanyl group, and DEX 5 μg in 3 ml saline in DEX group. The total volume of injected in each group was equal [3 mL].
Results: Before and at the delivery time, the visual analog scale [VAS] was substantially reduced in the DEX and fentanyl groups contrasted to the control group and comparable between the DEX and fentanyl groups. After-delivery, the VAS was lower in the DEX group compared to the fentanyl and control groups at 30 minutes and 60 minutes, and in the fentanyl group compared to the control group. At 90 minutes and 120 minutes, the DEX group continued to have substantially reduced VAS scores than the other two groups, and the fentanyl group had lower scores than the control group. The sensory analgesia duration was substantially longer in the DEX group contrasted to in the fentanyl and control groups. No substantial variation existed in complications and satisfaction across all groups.
Conclusion: DEX and fentanyl are superior to control as it reduces the pain during and after delivery with higher satisfaction without causing any significant complications for mothers and neonates with superiority of DEX to fentanyl.

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