skip to main content

COMPARISON OF EFFECTIVENESS OF GIVING COMBINATION OF DEXMEDETOMIDINE 5µg FENTANYL 25µg INTRATECHAL AND FENTANYL 25µg INTRATECHAL AS ADJUVANT TO BUPIVACAINE IN SPINAL ANESTHESIA AT HAJI ADAM MALIK CENTRAL GENERAL HOSPITAL MEDAN

1Study Program of Anesthesiology and Intensive Therapy, Faculty of, Indonesia

2Medicine, Universitas Sumatera Utara, Adam Malik General Hospital, Medan, Indonesia, Indonesia

3Department/Study Program Of Anesthesiology and Intensive Therapy,Faculty of, Indonesia

4 Medicine,Universitas Sumatera Utara, Adam Malik General Hospital, Medan, Indonesia, Indonesia

View all affiliations
Received: 10 Dec 2024; Revised: 2 May 2025; Accepted: 26 Jun 2025; Available online: 26 Jun 2025.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)
Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

Citation Format:
Cover Image
Abstract

ABSTRACT

Introduction:

Spinal anesthesia is a regional analgesia by blocking nerve cells in the subarachnoid space by local anesthetic drugs. Bupivacaine is the most common agent, however, the duration of analgesia is often short. However, this advantage is hampered by the limited duration of spinal anesthesia and the uncomfortable postoperative period when the effect wears off. To prolong the duration of analgesia, various drugs such as opioids and α2 adrenergic agonists can be used as adjuvants for intrathecal local anesthetics to improve the quality of spinal anesthesia. One of the most widely used opioids is Fentanyl while the α2 adrenergic agonist is Dexmedetomidine.

Objective:

To analyze the difference in effectiveness of the combination of Dexmedetomidine 5µg Fentanyl 25µg intrathecally with Fentanyl 25µg intrathecally as an adjuvant to Bupivacaine in spinal anesthesia.

Method:

This study is a double-blind randomized clinical trial to assess the comparison of the combination of Dexmedetomidine 5µg Fentanyl 25µg intrathecally with Fentanyl 25µg intrathecally as an adjuvant to Bupivacaine on the onset of block, duration of action and side effects in surgery with spinal anesthesia.

Results:

There were 32 samples with a distribution of 16 samples in each group. There was a significant difference in sensory and motor duration (p<0.001). The average sensory duration in the Fentanyl group was 2 hours 45 minutes and in Dexmedetomidine + Fentanyl 4 hours 25 minutes, while the motor duration in the Fentanyl group was 2 hours 30 minutes and Dexmedetomidine + Fentanyl was 4 hours 2 minutes.

Conclusion:

There is a comparison of the effectiveness of administering Dexmedetomidine 5 mcg + Fentanyl 25 mcg intrathecally and Fentanyl 25 mcg intrathecally as an adjuvant to 0.5% bupivacaine in the spinal where the Dexmedetomidine group had a longer duration of anesthesia than the Fentanyl group.

Keywords:Spinal Anesthesia, Dexmedetomidine, Fentanyl. Motor Duration, Sensory Duration.

Note: This article has supplementary file(s).

Fulltext View|Download |  Research Instrument
Untitled
Subject
Type Research Instrument
  Download (105KB)    Indexing metadata
 Research Instrument
Untitled
Subject
Type Research Instrument
  Download (66KB)    Indexing metadata
 Research Instrument
Untitled
Subject
Type Research Instrument
  Download (157KB)    Indexing metadata
Keywords: spinal anesthesia, dexmedetomidin, fentanyl

Article Metrics:

  1. DAFTAR PUSTAKA
  2. Sun, S., Wang, J., Bao, N., Chen, Y., Wang, J. Comparison of Dexmedetomidine and Fentanyl as local anesthetic adjuvants in spinal anesthesia: a systematic review and meta-analysis of randomized controlled trials. Drug Design Development and Therapy;2017;11:3413-3424
  3. Gupta, R., Verma, R., Bogra, J., Kohli, M., Raman, R., Kushwaha, JK. A comparative study of intrathecal Dexmedetomidine and Fentanyl as adjuvants to bupivacaine. Journal of Anaesthesiology Clinical Pharmacology;2011;27(3)
  4. Safari, F., Aminnejad, R., Mohajerani, SA., Farivar, F., Mottaghi, K., Safdari, H. Intrathecal Dexmedetomidine and Fentanyl as adjuvant to bupivacaine in duration of spinal block in addicted patients. Anesth Pain Med;2016;6(1):e26714
  5. Divya, VS., Raghu, R., Indira, P., Roy, S. Comparison of Dexmedetomidine and Fentanyl as adjuvants to 0,5% hyperbaric bupivacaine in spinal anesthesia in elective lower abdominal surgeries. Indian Journal of Clinical Anaesthesia;2021;8(2):257-264
  6. Weerink, MA., Struys, MM., Hannivoort, LN., Barends, CR., Absalom, AR., Colin, P. Clinical pharmacokinetics and pharmacodynamics of Dexmedetomidine. Clin Pharmacokinet;2017;56:893-913
  7. Nayagam HÁ, Singh NR, Singh HS. A prospective randomised double blind study of intrathecal Fentanyl and Dexmedetomidine added to low dose bupivacaine for spinal anesthesia for lower abdominal surgeries. Indian J Anaesth. 2014;58:430---5. 16
  8. Setiawan D, Perbandingan Mula Kerja dan Lama Kerja Blokade Antara Penambahan Ketamin dengan Fentanyl pada Bupivakain Sebagai Anestesi Spinal. Tesis. Universitas Negeri Sebelas Maret. Surakarta. 2012
  9. Safari, F., Aminnejad, R., Mohajerani, SA., Farivar, F., Mottaghi, K., Safdari, H. Intrathecal Dexmedetomidine and Fentanyl as adjuvant to bupivakain in duration of spinal block in addicted patients. Anesth Pain Med;2016;6(1):e26714
  10. Bgrami, Syed A. H.; Kumar, Manoj; Singh, Dipali1; Priye, Shio2. A comparison of Fentanyl, Dexmedetomidine and combination of Fentanyl with Dexmedetomidine on the quality of subarachnoid block and postoperative analgesia: A double-blind controlled study. Indian Journal of Anaesthesia 66(Suppl 4):p S220-S224, | DOI: 10.4103/ija.ija_701_21
  11. Khosravi F, Sharifi M, Jarineshin H. Comparative study of Fentanyl vs Dexmedetomidine as adjuvants to intrathecal bupivacaine in cesarean section: a randomized, double-blind clinical trial. Journal of Pain Research. 2020 Oct 7:2475-82
  12. Solanki SL, Goyal VK. Neuraxial Dexmedetomidine: wonder drug or simply harmful. Anesthesiology and pain medicine. 2015 Apr 1;5(2)
  13. Nayak A, Ninave S, Tayade S, Tayade H. Intrathecal Adjuvant Midazolam Versus Fentanyl With Hyperbaric Bupivacaine for Post-operative Analgesia in Women Undergoing Total Abdominal Hysterectomy. Cureus. 2023 Jun 17;15(6):e40565. doi: 10.7759/cureus.40565.PMID:37465806;PMCID:PMC10351601
  14. Li Z, Tian M, Zhang CY, et al. A randomised controlled trial to evaluate the effectiveness of intrathecal bupivacaine combined with different adjuvants (Fentanyl, clonidine and Dexmedetomidine) in caesarean section. Drug Res (Stuttg). 2015;65:5816
  15. D. S. Carollo, B. D. Nossaman, and U. Ramadhyani, “Dexmedetomidine: a review of clinical applications,” Current Opinion in Anaesthesiology, vol. 21, no. 4, pp. 457–461, 2008
  16. W. M. Abdelmageed, R. Shabana, A. Nassar, K. Elquesny, and H. Abushama, “Analgesic properties of a Dexmedetomidine infusion after uvulopalatopharyngoplasty in patients with obstructive sleep apnea,” Saudi Journal of Anaesthesia, vol. 5, no. 2, p. 150, 2011

Last update:

No citation recorded.

Last update: 2025-07-04 02:13:57

No citation recorded.