European Journal of Cardiovascular Medicine

Introduction and Aim: Sub-arachnoid blockade with addition of adjuvants such as Dexmedetomidine and Fentanyl is needed in arthroscopic knee procedures for prolongation of intraoperative and postoperative analgesia and improvement of block characteristics. The purpose of this study was to compare the time of onset of sensory and motor block, duration of spinal anaesthesia and hemodynamic effects between Group BD (Bupivacaine+Dexmedetomidine) and Group BF (Bupivacaine+Fentanyl) in adult patients undergoing elective arthroscopic knee procedures for sports injuries. Methods: Sixty patients of ASA I & II of either sex and age between 18-50 years of age were randomly allocated into two groups (30 patients each). Group BD received 12.5mg Bupivacaine plus 5µg prediluted Dexmedetomidine and Group BF received 12.5mg Bupivacaine plus 25µg Fentanyl. Time of onset of sensory and motor block, duration of spinal anaesthesia and hemodynamic effects were compared between two groups. Results: Patients in two groups were similar in terms of demographic profiles & ASA classification. The onset of sensory and motor blockade was faster in Group BD than Group BF & was statistically insignificant. (Sensory:4.62±1.52 vs 4.82±1.03 minutes and Motor: 5.52±1.4 vs 5.62±1.01 minutes; p>0.05) Duration of spinal anaesthesia was significantly longer in Group BD than Group BF (301 ± 18.4 vs 230.6 ± 11.2 minutes; p< 0.0001). The mean values of mean arterial pressure (MAP) and heart rate (HR) were comparable between two groups throughout intraoperative period. Both adjuvants are clinically relevant in regional anaesthetic practice with minimal adverse effects after careful selection of patients. Conclusions: In our study, Intrathecal Dexmedetomidine is associated with faster onset of sensory and motor blockade, prolonged duration of spinal anaesthesia and comparable hemodynamic stability as compared to Intrathecal Fentanyl.