Assistant Professor, Department of Anesthesiology, Dr.Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation, Chinna Avutapalli, Vijayawada, Andhra Pradesh-521286, India.

Assistant Professor, Department of Anesthesiology, Apollo Hospitals, K.K. Nagar, Madurai - 625 020, Tamilnadu, India.
Dexmedetomidine, ,Fentanyl ,Hypotension, ,Hemodynamics ,Gynaecology ,American Society of Anesthesiologists ,

The task of medicine is to preserve, restore health and to relieve pain. The main goals of these two are to understand pain. In a double blind, randomized study 60 patients experiencing lower abdominal surgeries acquire either with dexmedetomidine or fentanyl as adjuvant to bupivacaine for spinal anaesthesia . American Society of Anesthesiologists (ASA) class ASA I andASA II patients age ranges from 20 to 60 years of age were included. Onset of sensory and motor block ,highest stage reached , level regression ,time for rescue analgesia ,period of sensory and motor block and hemodynamics adjustments have been observed. Hypotension, distinct as a decrease of systolic blood pressure through greater than 30% from baseline or a fall below 90 mmHg, might be preserved with incremental IV doses of ephedrine 5 mg and IV fluid as obligatory. Bradycardia, defined as heart rate < 50 per mins, had been managed with IV atropine 0.6 mg. In adequate sensory and motor block beyond 15 minutes following the administration of the drug were considered as unsuccessful block and supplemented with standard anaesthesia. The maximum level of the block was identical in both groups .Onset time of sensory and motor block were almost equal in both groups. The number of patients requiring repeat spinal was equal in both the groups while one patient in group B is converted to GA in view of inadequate block. Group B had prolonged length of motor and sensory block and also better analgesic effect associated to group A. The study finds that the use of dexmedetomidine intrathecally as adjuvants to bupivacine during lower abdominal surgery provides better sensory and motor block as compared to fentanyl.

2 , 2 , 2012