Safety and Efficacy of Thoracic Segmental Spinal Anesthesia Using Fentanyl and Dexmedetomidine as Adjuvants to Ropivacaine in Patients Undergoing Laparoscopic Cholecystectomy: A Prospective Randomized Comparative Study

Abstract

Background: Segmental thoracic spinal anesthesia (STSA) is gaining attention as an alternative to general anesthesia as advanced regional technique that targets specific segment (dermatomes) to provide precise anesthesia in laparoscopic procedures. The present study aimed to compare efficacy and safety of Thoracic Segmental Spinal Anesthesia using fentanyl and dexmedetomidine as adjuvants to Ropivacaine in patients scheduled for laparoscopic cholecystectomy.
Methods: Seventy patients were divided randomly into two groups (n=35 each): Group F received hyperbaric and isobaric ropivacaine with fentanyl; Group D received the same with dexmedetomidine. Primary objective was to assess sensory block characteristics and secondary objective was to evaluate the onset of motor block, incidence of adverse effects like hypotension and bradycardia, and patient satisfaction (using Likert scale).
Results: Both groups showed similar onset times. Group D had significantly longer sensory block duration (223.2 min vs. 163.4 min, p < 0.001). Bradycardia and hypotension were more frequent in Group D. Patient satisfaction was higher in Group D (p=0.027).
Conclusion: Dexmedetomidine provided prolonged analgesia and higher satisfaction but was associated with greater incidence of bradycardia and hypotension.