Comparative Analysis of Analgesic Duration: Intrathecal Hyperbaric Levobupivacaine with Dexmedetomidine vs Morphine in Lower Segment Caesarean Sections

Background: Intrathecal adjuvants are commonly used to prolong postoperative analgesia following spinal anesthesia for caesarean section. Morphine is effective but associated with opioid-related adverse effects, while dexmedetomidine has emerged as a potential alternative. Aim: To compare the analgesic duration and safety profile of intrathecal hyperbaric levobupivacaine with morphine versus dexmedetomidine in parturients undergoing elective lower segment caesarean section. Material and Methods: A prospective randomized study involved 100 parturients divided into two groups. Group A received intrathecal hyperbaric levobupivacaine combined with 100 μg of morphine, with a mean age of 31.12 ± 4.08 years. Group B received intrathecal hyperbaric levobupivacaine with 3 μg of dexmedetomidine, with a mean age of 30.88 ± 4.32 years. Analgesic efficacy, hemodynamic parameters, adverse effects, and neonatal outcomes were assessed. Results: Both groups achieved adequate analgesia for 24 hours. Pain scores at 16 hours were significantly lower in the dexmedetomidine group. Opioid-related adverse effects were more frequent in the morphine group, while hemodynamic stability and neonatal outcomes were comparable. Conclusion: Intrathecal dexmedetomidine provides superior quality of analgesia with fewer adverse effects compared to morphine when used as an adjuvant to hyperbaric levobupivacaine for elective caesarean section.