Background. Intrathecal fentanyl in spinal anesthesia improves intra- and postoperative analgesia. Dexmedetomidine
is a fascinating adjuvant with regards to neuraxial anesthesia in children experiencing surgery for abdominal malignancy.
Patients and Methods. After endorsement by the institutional reviewing board (IRB) and guardians’ written informed
consent, this research was carried out on 60 pediatric malignancy patients scheduled for major abdominal
surgery. Children were randomly distributed into three groups (20 patients each): Group C: given 2mL of bupivacaine
0.5% (0.4 mg/kg) intrathecally, injected gradually over 20 seconds. Group F: the same as group C, plus fentanyl
0.2 lg/kg. Group D: the same as group C, plus dexmedetomidine 0.2 lg/kg. Pain at zero, two, four, six, 12, 18, and
24 hours postoperatively was evaluated by Face, Legs, Activity, Crying, and Consolability (FLACC) score. First analgesic
request and postoperative unfavorable effects were recorded for 24 hours postoperatively. Results. A significant
decrease was recognized in the mean FLACC score in groups D and F at six, eight, and 12 hours postoperatively,
in contrast to group C (P0.05). First analgesic request was significantly prolonged in group D (7.6760.57 hours),
in contrast to groups F and C (5.4061.09 hours and 4.2363.27 hours, respectively, P < 0.04). Paracetamol utilization
was significantly decreased in group D (316.67628.86 mg), in contrast to group C (391.00652.00 mg, P < 0.03),
without a significant difference between group F (354.44646.67 mg) and groups D and C (P > 0.05). Conclusions.
Adding dexmedetomidine and fentanyl to intrathecal bupivacaine improved postoperative analgesia following
abdominal surgery for cancer in children, with better overall analgesia of dexmedetomidine compared with
fentanyl.
Key Words: Intrathecal; Fentanyl; Dexmedetomidine; Bupivacaine; Pediatric Major Abdominal Cancer Surgery