Comparing fentanyl and dexmedetomidine as adjuvants to bupivacaine for spinal anesthesia in appendectomy: effects on peritoneal symptoms – a randomized clinical trial
Authors' conclusion
Dexmedetomidine provides superior peritoneal symptom control and prolonged analgesia compared to fentanyl as an intrathecal adjuvant in spinal anesthesia for appendectomy.
Study context
- Population
- ASA I–II patients scheduled for emergency open appendectomy under spinal anaesthesia
- Participants
- 150 patients
- Comparison
- Group D vs Group F
- Primary endpoint
- Incidence of peritoneal symptoms (abdominal discomfort, visceral pain, nausea, vomiting)
Methodological detailsdouble-blinded
- Double-blinded
Primary result
As reported in the abstract
Peritoneal symptoms
Abdominal discomfort, Group D vs Group F
9.5% vs. 33.3%
Visceral pain, Group D vs Group F
10.8% vs. 53.3%
Nausea, Group D vs Group F
9.5% vs. 34.7%
Vomiting, Group D vs Group F
6.8% vs.34.7%
Further findings
Time to first rescue analgesia
- Significantly longer in the dexmedetomidine group vs fentanyl (min)
- 396 vs. 243 min; P < 0.001
VAS pain score · four and six hours postoperatively
- Significantly higher in group F than in group D
- P < 0.001
Safety
Bradycardia
P < 0.001
Respiratory depression
- No cases observed
Hypotension and shivering
- Hypotension slightly more frequent in group D, shivering more prevalent in group F; neither difference statistically significant
Original publication
Comparing fentanyl and dexmedetomidine as adjuvants to bupivacaine for spinal anesthesia in appendectomy: effects on peritoneal symptoms – a randomized clinical trial. Perioper Med (Lond). Published 14 November 2025. doi:10.
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