Comparative Analysis of Intrathecal Bupivacaine Alone and in Combination with Intravenous Dexmedetomidine or Butorphanol for Lower Abdominal Surgeries

Abstract

Background: Subarachnoid block (SAB) is commonly preferred over general anesthesia (GA) for lower abdominal surgeries due to its superior efficacy and safety.
Aim and Objective: This study aims to evaluate the impact of intravenous (IV) adjuvants—dexmedetomidine (DEX) and butorphanol (BUT)—on intrathecal (IT) Bupivacaine (BUP) during lower abdominal surgeries.
Materials and Methods: A randomized, double-blind, prospective study was conducted on 60 patients scheduled for lower abdominal surgery. Participants were randomly divided into three groups: Group B received IT BUP alone, Group B+DEX received IT BUP with IV DEX, and Group B+BUT received IT BUP with IV BUT. Primary outcomes measured included sensory and motor block duration, postoperative pain, sedation, and adverse effects (AEs).
Results: Both DEX and BUT as IV adjuvants significantly prolonged the duration of sensory and motor blocks compared to IT BUP alone. Patients in the adjuvant groups showed faster motor block onset and longer sensory block duration. Lower pain scores were observed in these groups, indicating better analgesia. Sedation scores were higher in the adjuvant groups, while AEs were similar across all groups. DEX also notably reduced the incidence of shivering.
Conclusion: DEX and BUT are effective IV adjuvants to IT BUP, improving the anesthetic quality and postoperative analgesia without increasing the risk of AEs.