Comparative Study of Fentanyl vs Dexmedetomidine as Adjuvants to Intrathecal Bupivacaine in Cesarean Section

Background: Spinal anesthesia remains the preferred method for cesarean deliveries because of its deep sensory block and minimal negative consequences on the fetus and mother.
Objective: This research aimed to compare the impacts of dexmedetomidine and fentanyl when used as adjuvants to intrathecal bupivacaine during elective cesarean section, assessing their impact on period of spinal anesthesia, quality of analgesia, hemodynamic stability, incidence of side effects, and neonatal outcomes.
Methods: This was randomized, double-blind clinical research involving sixty parturients that were classified into 2 groups; every group included thirty parturients. Group (A): 30 patients were administered ten milligrams of hyperbaric bupivacaine 0.5% + 5 ug dexmedetomidine, and Group (B): 30 patients were administered ten milligrams of hyperbaric bupivacaine 0.5% + 25 ug fentanyl.
Results: An insignificant variance was recorded according to the pain score at the 1^st hour, third hour, and sixth hour (P-value > 0.05), period of motor block and duration of operation, bradycardia, hypotension, shivering, nausea/vomiting, and respiratory depression, and Apgar score at one- and five-min (P>0.05). Statistically significant variance was recorded between the examined groups according to duration of analgesia (P-value < 0.05).
Conclusion: Dexmedetomidine (5 μg) is a more effective adjuvant for pain management following surgery within a cesarean section under spinal anesthesia compared to fentanyl. It prolongs analgesia and reduces the need for additional pain medication, with few opioid-related negative consequences involving respiratory depression and nausea, making it a more favorable choice.