Abstract

Background: Intrathecal opioids are the gold standard for the treatment of post-operative pain with Buprenorphine adjudged as the most effective due its potent and prolonged effects. However, over the years it is losing popularity due to dose dependant side effects such as pruritus, nausea, vomiting and the most feared risk of delayed respiratory depression. Hence the search for an agent which can provide potent postoperative analgesia as comparable to morphine without its side effects still continues.
Aim & Objective: study intrathecal Dexmedetomidine 10mcg and Buprenorphine 75mcg used as adjuvant to 0.5% hyperbaric Bupivacaine to study- The onset of sensory block., Time of achieving highest level of sensory block. The onset of motor block. The Hemodynamic Effects. The Adverse Effects. Methods: Randomized clinical trial, Study setting:  Anaesthesia Department of tertiary care centre. Study duration: from April 2021 to March 2022 Study population: All patients with cataract requiring surgery admitted in tertiary care center. Sample size: 100. Results:  Dexmedetomidine group- 4 (8%) patients were less than 20 years of age, 34 (68%) patients were between 20-40 years of age, 12 (24%) patients were between 41-58 years of age. Buprenorphine group- 1(2%) patient was less than 20 years of age ,34(68%) were between 20-40 years of age, 15(30%) were between 41-58 years of age. 47(94%) patients in Dexmedetomidine group were males and 3(6%) were females.38(76%) patients in Buprenorphine group were males and 12(24%) were females. Dexmedetomidine group 47(94%) patients were ASA 1 grade whereas 3(6%) patients were ASA 2 grade. Buprenorphine group 43(86%) patients were ASA 1 grade whereas 7(14%) patients were ASA 2 grade. Dexmedetomidine group was earlier with mean 3.06 ± 0.45 min whereas 3.46 ± 0.59 min in buprenorphine group, P value 0.0002492 which was significant as it was less than 0.05. so onset of sensory block was significantly earlier in Dexmedetomidine group than Buprenorphine group. No significant difference was seen in the distribution of maximum sensory level among patients in both the group as observed p value is 0.532 which was >0.05. From 10 min onwards, Hollmen score was 3 among both group which denotes no perception of pinprick 15min after giving spinal anaesthesia. Conclusions: Time of onset of sensory block and motor block was earlier in Dexmedetomidine group   than the Buprenorphine group. Duration of sensory block and motor block was prolonged in Dexmedetomidine group than the Buprenorphine group. Two segment regression of sensory level was significantly later among Dexmedetomidine group than Buprenorphine group.