Randomized Comparative Study of Intrathecal Administration of Dexmedetomidine-Fentanyl for Labour Pain
Randomized Comparative Study of Intrathecal Administration of Dexmedetomidine-Fentanyl for Labour Pain
DOI:
https://doi.org/10.70284/njirm.v9i1.1859Keywords:
Combine, Dexmedetomidine, Fentanyl, Labour PainAbstract
Introduction: Dexmedetomidine used in pregnancy as it does not significantly cross the placenta due to its high placental retention. Also it has no adverse effects on mother or fetus in many studies. Our purpose was to evaluate the effect of combination of IT dexmedetomidine and fentanyl on maternal and neonatal outcomes during labour in comparison to IT dexmedetomidine or IT fentanyl. Methods: Age groups between 20 – 40 years were included in the study. A total of 150 patients were included in the study. All the included patients were scheduled for normal vaginal delivery with uncomplicated delivery. Any patients with liver, kidney disease, cardiac problem, any allergy to local anesthesia, fetal compromise or patient refusal were excluded from the study. The informed consent was taken from all the patient included in the study. Results: Onset of analgesia was faster and duration of analgesia was longer in group C than in the two other groups (p-value <0.001), 18 patients in A group, 19 patients in group B and 15 patients in group C needed top-ups of 10ml of 0.125% bupivacaine till delivery of baby. Discussion & Conclusion: Our study concluded that Addition of 5 μg intrathecal dexmedetomidine to 10 μg fentanyl prolonged the duration of analgesia. The combination decreases the incidence of side effects in comparison to IT 10 μg dexmedetomidine or IT 20 μg fentanyl alone.
References
2. Gould III HJ: Understanding pain: What it is, why it happens, and how it's managed: Demos Medical Publishing, 2006.
3. Naaz S, Bandey J, Ozair E, Asghar A: Optimal Dose of Intrathecal Dexmedetomidine in Lower Abdominal Surgeries in Average Indian Adult. Journal of clinical and diagnostic research: JCDR 2016, 10:UC09.
4. Torske KE, Dyson DH: Epidural analgesia and anesthesia. Veterinary Clinics: Small Animal Practice 2000, 30:859-74.
5. Sun Y, Xu Y, Wang G-N: Comparative evaluation of intrathecal bupivacaine alone, bupivacaine-fentanyl, and bupivacaine-dexmedetomidine in caesarean section. Drug research 2015, 65:468-72.
6. Donatelli F, Tran D, Mistraletti G, Carli F: Epidural analgesia in the post-anaesthesia care unit. Current drug targets 2005, 6:795-806.
7. Robertson S, Taylor P: Pain management in cats—past, present and future. Part 2. Treatment of pain—clinical pharmacology. Journal of Feline Medicine & Surgery 2004, 6:321-33.
8. Koyyalamudi V, Sen S, Patil S, Creel JB, Cornett EM, Fox CJ, Kaye AD: Adjuvant Agents in Regional Anesthesia in the Ambulatory Setting. Current pain and headache reports 2017, 21:6.
9. Simmons SW, Taghizadeh N, Dennis AT, Hughes D, Cyna AM: Combined spinalâ€epidural versus epidural analgesia in labour. The Cochrane Library 2012.
10. 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, 27:339.
11. Mohamed AA, Fares KM, Mohamed S: Efficacy of intrathecally administered dexmedetomidine versus dexmedetomidine with fentanyl in patients undergoing major abdominal cancer surgery. Pain physician 2012, 15:339-48.
12. HONG JY, Kim W, Yoon Y, Choi Y, KIM SH, Kil H: Effects of intravenous dexmedetomidine on lowâ€dose bupivacaine spinal anaesthesia in elderly patients. Acta Anaesthesiologica Scandinavica 2012, 56:382-7.