Effectiveness of Intrathecal Dexmedetomidine and Fentanyl as Adjuvant to Bupivacaine for Labour Analgesia: A Study Protocol

Background: The most commonly used labour analgesia is epidural. Another alternative method is intrathecal low dose analgesic, given for providing labour analgesia in the areas where the epidural kit, multiparameter monitors, staff members scarcity is present. Fentanyl has been used widely to decrease motor block effect of local anaesthetics during labour, presence of these opioids along with local anaesthetics can cause pruritus and respiratory depression. Selective α2- agonist Dexmedetomidine (DMT) helps in providing stable haemodynamic parameters, and an effective intraoperative and postoperative analgesia. This study aims to compare the effectiveness of an intrathecal analgesia during labor, using bupivacaine in combination with dexmedetomidine and fentanyl in terms of quality and duration of analgesia.

Materials and Methods: This will be a prospective comparative observational study. Total 80 patients will be included in the study and assigned to two groups by computerized randomization method. GROUP BD (n=40) will receive an intrathecal 0.5% hyperbaric bupivacaine dose 2.5 mg along with dexmedetomidine dose 2.5 μg .GROUP BF (n=40) will receive an intrathecal 0.5% hyperbaric bupivacaine 2.5mg with fentanyl 25mcg. Data will be analysed and Quality and duration of analgesia will be compared for both groups.

Expected Results: Significant difference is expected in labor analgesia and safety profile with the combination of intrathecal bupivacaine and dexmedetomidine compared to combination of bupivacaine and fentanyl.