Efficacy of Intrathecal Dexmedetomidine on Post-operative Pain Relief in General Surgical Cases

Abstract

 Objectives: To compare the efficacy of intrathecal bupivacaine combined with dexmedetomidine versus bupivacaine alone
in providing postoperative analgesia for patients undergoing general surgical procedures under spinal anesthesia.
Study design and setting: A single-blind interventional study was conducted by the Anesthesiology Department at Farooq
Hospital (ASMC), Rawalpindi, from January 16th to December 25, 2024.
Methodology: After ethical approval from the Research Advisory Committee of Akhtar Saeed Medical College, Rawalpindi,60
patients (placed in ASA classes I-III) undergoing elective general surgical cases in spinal block were enrolled and randomized
into two groups (by lottery method). Group A received intrathecal 1.5 mL hyperbaric bupivacaine 0.75% (15 mg) alone,
while Group B received the same dose of bupivacaine with 5ìg dexmedetomidine. Standard ASA monitoring, preloading
with isotonic crystalloids, and spinal anaesthesia at the L3–L4 level were employed using a 26-G spinal needle. Hemodynamic
parameters, adverse effects and need for rescue analgesia were documented. Statistical analysis done by SPSS v26(with
p<0.05 as significant).
Results: Demographic parameters (age, weight, BMI) were comparable between groups. Mean postoperative analgesia
duration was significantly longer in the dexmedetomidine group (20.18 ± 3.48 h) compared to group B (11.78 ±1.64 h, p
< 0.05). The dexmedetomidine group required fewer rescue opioid doses, reflecting an opioid-sparing effect.
Conclusions: Intrathecal dexmedetomidine to bupivacaine in spinal anaesthesia for general surgical cases significantly
prolongs the postoperative analgesia period