Comparison of Dexmedetomidine and Fentanyl as an Adjuvant to Lidocaine 5% for Spinal Anesthesia in Women Candidate for Elective Caesarean
DOI:
https://doi.org/10.3889/oamjms.2018.365Keywords:
Dexmedetomidine, Fentany, Pain, Spinal Anesthesia, LidocaineAbstract
AIM: This study aimed to compare the effect of Dexmedetomidine and fentanyl as an adjuvant to lidocaine 5% in spinal anaesthesia to increase post-operative analgesia among women candidates for elective caesarean.
METHODS: Eighty-four pregnant women candidates for caesarian were randomly divided into fentanyl and Dexmedetomidine groups. In the first group, 25 μg fentanyl was added to lidocaine 5% while in the second group, 0.5 μg per kilogram Dexmedetomidine was added to lidocaine 5%. After the operation, a pain score of the patients in recovery and within 4, 12 and 24 hours after the operation, the average length of analgesia and the average amount of the analgesics taken within 24 hours and after the operation were recorded.
RESULTS: The average length of postoperative anaesthesia and the average amount of the drug taken within the first 24 hours after the operation in fentanyl group was more than the Dexmedetomidine group (P = 0.01). Shivering in Dexmedetomidine group was more common than what was observed in the fentanyl group (P = 0.001). Higher rates of nausea-vomiting were observed in the fentanyl group (P = 0.001).
CONCLUSIONS: Fentanyl results in a longer period of postoperative analgesia and less consumption of drugs after the operation. Fentanyl is recommended in caesarian.
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Martin TC, Bell P, Ogunbiyi O. Comparison of general anaesthesia and spinal anaesthesia for Carsarean Section in Antigua and Barbuda. West Indian Med. 2007; 56:330-333.
Samina I. Postoperative analgesia following Caesarean Section intravenous patient-controlled analgesia versus conventional continuous infusion. Open Journal of Anesthesiology. 2012; 2:120-126. https://doi.org/10.4236/ojanes.2012.24028
Pazuki S, Kamali A, Shahrokhi N. Comparison of the Effects of Intrathecal Midazolam and Tramadol with the Conventional Method of Postoperative Pain and Shivering Control after Elective Cesarean Section. Biomedical & Pharmacology Journal. 2016; 9:995-1003. https://doi.org/10.13005/bpj/1039
Behdad S. Analgesic effect of intravenous Ketamine during spinal anesthesia in pregnant women undergone Caesarean Section. Anesth Pain Med. 2013; 3:230-233. https://doi.org/10.5812/aapm.7034 PMid:24282773 PMCid:PMC3833040
Gupta M. Comparision of intrathecal Dexmedetomidine with Buprenorphine as adjuvant to Bupivacaine in spinal anaesthesia. J Clin Diagn Res. 2014; 8:114-117. PMid:24701498 PMCid:PMC3972523
Moraca RJ, Sheldon DG, Thirlby RC.The role of epidural anesthesia and analgesia in surgical practice.Ann Surg. 2003; 238:663-673. https://doi.org/10.1097/01.sla.0000094300.36689.ad PMid:14578727 PMCid:PMC1356143
Skarmas SK. Comparision of pre-mixed and sequentially intrathecal administration of Clonidine with hyperbaric Bupivaxaine in Caesarean Sections. International Multispecialty. Journal of Health. 2015; 1:20-24.
Gupta R, Verma R, Bogra J, Kohli M, Raman R, Kushwaha JK. A comparative study of intrathecal Dexmedetomidine and Fentanyl as adjuvants to Bupivacaine. J Anaesthesiol Clin Pharmacol. 2011; 27:339-343. https://doi.org/10.4103/0970-9185.83678 PMid:21897504 PMCid:PMC3161458
Christiansson L. Update on adjuvants in regional anaesthesia. Periodicum Biologrum. 2009; 111:161-170.
Bowdle T. Adverse effect of opioid agonists and agonist-antagonists in anaesthesia. Drug Saf. 1998; 19:173-189. https://doi.org/10.2165/00002018-199819030-00002 PMid:9747665
Li C, Li Y, Wang K, Kong X. Comparative evaluation of Remifentanil and Dexmedetomidine in general anesthesia for cesarean delivary. Med Sci Monit. 2015; 21:3806-3813. https://doi.org/10.12659/MSM.895209 PMid:26638888 PMCid:PMC4676355
Lee M, Ko JH, Kim EM, Cheung MH, Choi YR. The effect of intravenous Dexmedetomidine as spinal anaesthesia. Korean J Anaesthesiol. 2014; 67:252-257. https://doi.org/10.4097/kjae.2014.67.4.252 PMid:25368783 PMCid:PMC4216787
Abdalla W, Ammar MA, Tharwat AI. Combination of dexmedetomidine and remifentanil for labor analgesia: A double-blinded, randomized, controlled study. Saudi J Anaesth. 2015; 9:433-438. https://doi.org/10.4103/1658-354X.159470 PMid:26543463 PMCid:PMC4610090
Mahendru V, Tewari A, Katyal S. A comparison of intrathecal dexmedetomidine, clonidine, and fentanyl as adjuvants to hyperbaric bupivacaine for lower limb surgery: A double blind controlled study. J Anaesthesiol Clin Pharmacol. 2013; 29:496-502. https://doi.org/10.4103/0970-9185.119151 PMid:24249987 PMCid:PMC3819844
Agrawal A, Agrawal S, Payal Y. Comparison of block characteristics of spinal anesthesia following intravenous Dexmedetomidine and Clonidine. J Anaesthesiol Clin Pharmacol 2016; 32:339-343. https://doi.org/10.4103/0970-9185.188830 PMid:27625482 PMCid:PMC5009840
Xiawei L, Jinlei Z, Riyong W, Fangfang X. Dexmedetomidine Added to Local Anesthetic Mixture of Lidocaine and Ropivacaine Enhances Onset and Prolongs Duration of a Popliteal Approach to Sciatic Nerve Blockade. Clinical Therapeutics Journal. 2017; 39:89-97. https://doi.org/10.1016/j.clinthera.2016.11.011 PMid:27955918
Khezri MB, Rezaei M, Delkhosh Reihany M, Haji Seid Javadi E. Comparison of postoperative analgesia effect of intrathecal Clonidine and Fentanyl added to Bupivacaine in patients undergoing Cesarean Section. Pain Res Treat. 2014; 2014:513628
Parmar K. Effect of intrathecal Ropivacaine with Dexmedetomidine for operative and postoperative analgesia. Journal of Evaluation of Medical and Dental Sciences. 2014; 3:2917-2925. https://doi.org/10.14260/jemds/2014/2225 PMid:25071006
Mahmoud M, Sami A, Aloweidi A. Effect of dexmedetomidine added to spinal bupivacaine for urological procedures. Saudi J Anaesth. 2009; 30:365-370.
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Copyright (c) 2018 Alireza Kamali, Ronak Azadfar, Shirin Pazuki, Maryam Shokrpour
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