Comparing Dexmedetomidine and Fentanyl Added to Heavy Bupivacaine for Spinal Anesthesia in Lower Limb Orthopedic Surgery Evaluating Effects on Blood Pressure, Heart Rate, and Motor Block Timing

What this Trial Is About

Researchers are evaluating the effects of adding dexmedetomidine or fentanyl to heavy bupivacaine spinal anesthesia in patients undergoing elective lower limb orthopedic surgeries. This study aims to compare the hemodynamic stability, onset, and duration of motor block with these adjuvants, addressing the current limitation of short action duration of local anesthetics. Both drugs are studied for their potential to enhance analgesia while monitoring possible side effects. Participants are randomly assigned to receive either 4 g dexmedetomidine or 25 g fentanyl added to 3 mL of 0.5% hyperbaric bupivacaine via intrathecal injection. The anesthesia is administered after standard preloading and under strict aseptic technique, with continuous monitoring of vital signs including blood pressure and heart rate during surgery. The study includes detailed assessments of motor block onset and duration using the Modified Bromage scale, with treatment adjustments for any complications such as hypotension or bradycardia. During the study, participants undergo baseline clinical evaluation and continuous intraoperative monitoring of vital signs every 15 to 30 minutes over approximately 90 minutes. Researchers document the time to full motor block and its resolution, as well as any intraoperative complications like nausea, vomiting, or respiratory depression. The primary outcomes focus on motor block duration and onset, along with heart rate and blood pressure stability, all assessed within specific time frames. The total participation period aligns with the surgery and immediate recovery phase, emphasizing safety and efficacy monitoring.

Comparative Analysis of Intraoperative Effect Dexmedetomidine and Fentanyl as an Adjuvant to Heavy Bupivacaine in Spinal Anaesthesia in Lower Limb Orthopedic Surgeries to Evaluate the Hemodynamic Stability and Onset and Duration of Motor Block of Using Intrathecal Dexmedetomidine and Fentanyl