As intrathecal adjuncts in labor analgesia, Dexmedetomidine and Fentanyl were compared for safety and effectiveness in a prospective randomized controlled trial.

The study included 120 parturients and segregated them into Group A and Group B. Group A received Bupivacaine 2.5 mg (0.5 mL diluted to 2 mL) + 20 μg of Dexmedetomidine in 1 mL saline intrathecally (total volume: 3 mL) while Group B received Bupivacaine 2.5 mg (0.5 mL diluted to 2 mL) + 15 μg of Fentanyl in 1 mL saline intrathecally (total volume: 3 mL). Primary outcomes included successful analgesia, delivery method, and neonatal outcome. Participants' analgesia onset and duration, level of motor block, and adverse effects on the mother and fetus were all tracked.

A total of 108 expectant mothers (Group A: 57; Group B: 51) reported having enough analgesia, and 74 had vaginal deliveries (Group A: 41; Group B: 44). Normal vaginal delivery rates were greater in Group B. Group A recorded earlier analgesia onset that continued for greater duration compared to Group B, as shown in Table 1:

In none of the groups were there any significant negative effects. Fetal heart rate variability was attenuated, according to ultrasonography. Newborns in Group A were found to have low heart rates.

When used as an adjuvant, intrathecal Fentanyl raised the likelihood of vaginal delivery. With intrathecal Dexmedetomidine, analgesia intensity and duration were improved.