1*Final Year Postgraduate, Department of Anesthesiology and Critical Care, Sree Balaji Medical College and Hospital, Tamil Nadu, India; Bharath Institute of Higher Education and Research. Email: luckyprasanna96@gmail.com (Corresponding Author)
2Associate Professor, Department of Anesthesiology, Sree Balaji Medical College and Hospital, Tamil Nadu, India; Bharath Institute of Higher Education and Research. Email: Bhagyavardhan@gmail.com
3Professor, Department of Anesthesiology, Sree Balaji Medical College and Hospital, Tamil Nadu, India; Bharath Institute of Higher Education and Research. Email: Kalamhn@gmail.com
4Assistant Professor, Department of Anesthesiology, Sree Balaji Medical College and Hospital, Tamil Nadu, India; Bharath Institute of Higher Education and Research. Email: purushmbbs@gmail.com ORCID: 0000-0002-6202-0424
Received: 15th Feb, 2026; Revised: 27th Feb 2026; Accepted: 20th Mar, 2026; Available Online: 5th Apr, 2026
Background: Optimization of spinal anesthesia using adjuvants is essential for improving analgesic efficacy and perioperative hemodynamic stability in orthopedic surgeries. Dexmedetomidine, an α2-adrenergic agonist, has gained attention as a neuraxial adjuvant, while fentanyl remains a commonly used opioid adjunct. This study aimed to compare the analgesic and hemodynamic effects of intrathecal dexmedetomidine–fentanyl combination versus dexmedetomidine alone in patients undergoing lower limb orthopedic surgeries.
Methods: This prospective randomized study was conducted at a tertiary care center in Chennai in 2022. Thirty patients (ASA I–II), aged 18–60 years, undergoing elective lower limb orthopedic surgeries under spinal anesthesia were enrolled and divided into two groups (n=15 each). Group A received dexmedetomidine (10 µg) with fentanyl (25 µg), while Group B received dexmedetomidine (10 µg) with saline. Sensory and motor block onset, duration of analgesia, hemodynamic parameters, and postoperative pain scores (VAS) were assessed.
Results: Group A demonstrated significantly faster onset of sensory block (6.6 ± 0.90 min vs 8.2 ± 0.97 min; p=0.0001) and motor block (7.13 ± 0.80 min vs 9.93 ± 0.92 min; p=0.0001) compared to Group B. The duration of analgesia was significantly prolonged in Group A (427.3 ± 89.25 min vs 265.0 ± 71.27 min; p=0.0001). Postoperative pain scores were significantly lower in Group A at 0, 6, and 24 hours (p<0.01). Hemodynamically, Group A exhibited lower heart rate and systolic blood pressure in the early intraoperative period (p<0.05), while both groups maintained overall stability without clinically significant adverse effects.
Conclusion: The combination of intrathecal dexmedetomidine and fentanyl provides superior analgesic efficacy, faster onset of blockade, and prolonged postoperative analgesia compared to dexmedetomidine alone, while maintaining stable hemodynamics. This combination represents an effective strategy for enhancing spinal anesthesia outcomes in lower limb orthopedic surgeries.
Keywords: Analgesia, Dexmedetomidine, Fentanyl, Spinal Anesthesia, Hemodynamics, Orthopedic Procedures, Postoperative Pain, Regional Anesthesia
How to cite this article: Gurram LP, Botta B, Balasubramanian K, Ramamurthy P. Comparative Analysis of Analgesic and Hemodynamic Effects of Dexmedetomidine-Fentanyl versus Dexmedetomidine in Lower Limb Orthopedic Surgeries Under Regional Anesthesia: A Cross-Sectional Study. Int J Drug Deliv Technol. 2026;16(4): 21. DOI: 10.25258/ijddt.16.4.3
Source of support: Nil.
Conflict of interest: None