Objectives: Addition of adjuvants to low dose bupivacaine potentiates its analgesic effects in labour analgesia. Dexmedetomidine and fentanyl as adjuvants to bupivacaine were compared in epidural labour analgesia.

Methods: This was a prospective randomized, double blind study. 60 healthy term parturients in active labour were randomly allocated into 2 groups of 30 each. Group BD received 15 ml of 0.0625% Inj. bupivacaine with 2μg/ml Inj. fentanyl (BD) and group BF 0.0625% Inj. bupivacaine with 1.5μg/ml Inj. dexmedetomidine (BF). VAS , sedation scores, modified four grade bromage scale, hemodynamics, peripheral oxygen saturation were recorded at baseline and regular intervals. When VAS was ≥ 4, subsequent doses of 5ml of the respective group drug was administered. Parturients were ambulated when bromage scale was 0 with no postural hypotension. The labour outcome, neonatal Apgar scores and side effects if any were noted.

RESULTS :The duration of analgesia was prolonged in BD parturients (132.8±45.7) than BF (85±22.5)(p<0.0001). The number of top ups required in BF was more (1.8±1.4) than BD (0.17±0.4)(p<0.0001). The sedation scores were significantly high and VAS significantly low (p<0.05) in group BD. 26 parturients in BF could be ambulated and only 3 in BD (p <0.001).There was no hypotension or bradycardia till delievery in both groups. The APGAR scores were comparable(p>0.05). The side effects were significantly more in BF than BD(p<0.05) parturients.

CONCLUSION : Dexmedetomidine provides longer duration of analgesia, reduces local anesthetic consumption compared to fentanyl, when used for labour analgesia, but produces significant motor blockade and maternal sedation.