Comparative Evaluation of Two Doses of Intrathecal Dexmedetomidine (3 µg vs 5 µg) as an Adjuvant to Hyperbaric Ropivacaine in Caesarean Section: A Randomised Double-blind Controlled Trial

Introduction: Spinal anaesthesia is commonly used for caesarean sections because of its rapid onset, reliable sensory and motor blockade, and excellent analgesia. Ropivacaine is preferred for its improved safety profile and reduced motor block. Aim: To assess the impact of adding dexmedetomidine (3 μg vs 5 μg) to intrathecal hyperbaric ropivacaine in patients undergoing elective caesarean section. Materials and Methods: This randomised, double-blind, controlled study was conducted at the Department of Anaesthesiology, Government Medical College, Gondia, Maharashtra, India, from July 2023 to January 2025. A total of 90 parturients were enrolled and received spinal anaesthesia with 12.5 mg of intrathecal ropivacaine. Participants were randomly assigned to one of three groups: ropivacaine alone (R group), ropivacaine with 3 µg dexmedetomidine (RD3 group), and ropivacaine with 5 µg dexmedetomidine (RD5 group). The study evaluated intraoperative sensory and motor block characteristics, haemodynamics, postoperative analgesia, and adverse events. Statistical analysis was performed using the Chi-square test and one-way Analysis of Variance (ANOVA). Results: The demographic characteristics of patients in all three groups were comparable regarding age, Body Mass Index (BMI), height, and gestational age (p-value >0.05). Addition of dexmedetomidine to intrathecal ropivacaine significantly enhanced anaesthetic efficacy. Both RD3 and RD5 groups showed faster onset of sensory block to T10, T4, and peak levels compared to the R group (p-value