DOI: https://doi.org/10.36347/sasjs.2026.v12i02.010

Pages: 173-179

Background: Spinal anesthesia is commonly used for lower limb and perianal surgeries, offering effective intraoperative and early postoperative analgesia, though achieving optimal pain control remains a challenge due to the limited duration of standard local anesthetics and potential opioid-related side effects. This study aimed to compare the postoperative analgesic efficacy, safety, and patient satisfaction of intrathecal dexmedetomidine versus fentanyl in patients undergoing perianal surgery. Methods: This quasi-experimental study at the Departments of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, included 64 perianal surgery patients receiving intrathecal bupivacaine with either fentanyl or dexmedetomidine. Sensory and motor blocks, hemodynamics, pain, analgesia duration, adverse effects, and satisfaction were recorded and analyzed using SPSS 23.0 (p < 0.05). Results: In 64 patients (32 per group), demographics were comparable (mean age 45.3 ± 8.5 y, 75% male, 57.8% ASA I). Group B had longer sensory (292.1 vs 205.6 min) and motor blocks (162.5 vs 126.5 min) and prolonged analgesia (278.5 ± 16.2 vs 198.7 ± 25.2 min). VAS scores were lower in Group B at 2–6 h (p ≤ 0.033). Adverse effects were mild, with pruritus only in Group A, and patient satisfaction was high and similar between groups (4.58 ± 0.5 vs 4.53 ± 0.5). Conclusion: Intrathecal dexmedetomidine provides superior and prolonged postoperative analgesia with good safety and high patient satisfaction in perianal surgeries.