الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
Patients undergoing orthopedic surgery are prone to developing postoperative urinary retention (POUR). They have an estimated relative risk of 8% to 55% higher than other surgical patients. Dexmedetomidine is an alternative to intrathecal fentanyl which is also added to other local anesthetics to increase anesthesia and analgesia. It has improved spinal anesthesia and reduced the anesthetic drug related side effects.
In this study, we aimed to compare the effects of Dexmedetomidine or Fentanyl added to intrathecal bupivacaine in knee arthroscopic procedures in terms of the occurrence of postoperative urinary retention. This prospective randomized clinical study was conducted at tertiary care hospital at Ain Shams University hospitals from September 2021 till March 2022 and performed on a total of 70 patients who assigned for knee joints orthoscopic surgery.
The current study results revealed that the incidence of postoperative urine retention in dexmedetomidine group was 5.7% while was 28.6% in Fentanyl group, the difference was statistically significant. The current study results revealed that the Time to achieve sensory block T10 was significantly shorter in dexmedetomidine group and the duration of motor block statistically was significantly longer in dexmedetomidine group.
As regards postoperative pain score (VAS), the current study revealed that Postoperative pain statistically was significantly lower in Dexmedetomidine group than in Fentanyl group during the six hours of follow up. The current study results revealed that Postoperative complication of shivering statistically was non-significantly less frequent in Dexmedetomidine group.
We concluded that when compared to fentanyl, our study revealed that intrathecal dexmedetomidine, as adjuvant to local anesthetics for intrathecal injection, can statistically significantly prolong the duration of sensory and motor block, as well as better analgesia in terms of VAS, meanwhile significantly reducing the incidence of urinary retention.
CONCLUSION
When compared to fentanyl, our study revealed that intrathecal dexmedetomidine, as adjuvant to local anesthetics significantly reduces the incidence of urinary retention and prolongs the duration of motor block, as well as better post operative analgesia.
RECOMMENDATIONS
• Intrathecal dexmedetomidine as an adjuvant to spinal bupivacaine in knee arthroscopic surgeries compared to fentanyl, is recommended for its longer duration of motor block, and low incidence of urinary retention.
• The present study can burden the knowledge and shed some light on future prospective studies with larger sample sizes demonstrating the long-term efficacy and safety of intrathecal dexmedetomidine.