Comparative study of Epidural 0.75% Ropivacaine with Dexmedetomidine and 0.75% Ropivacaine alone in lower abdominal and lower limb surgeries

Abstract

Background Epidural anaesthesia is one of the most common regional anaesthetic techniques used for lower abdominal and lower limb surgeries. The advantages of epidural anaesthesia being, it provides effective surgical anaesthesia and can meet the extended duration of surgical needs, provides prolonged post operative analgesia, reduces the incidence of hemodynamic changes. Various adjuvants are being used with local anesthetics for prolongation of intra operative and postoperative analgesia in epidural block for lower abdominal and limb surgeries. Dexmedetomidine, the highly selective ?2 adrenergic agonist is a new neuroaxial adjuvant gaining popularity. Aim To study the synergistic effect of adding dexmedetomidine to ropivacaine 0.75% in epidural anaesthesia for lower abdominal and lower limb surgeries. Materials and Methods One Hundred Patients scheduled for various lower abdominal and lower limb surgeries under epidural anesthesia participated in this study. They were assigned to: Control Group (n = 50), 15ml of 0.75% ropivacaine and Dexmedetomidine Group (n = 50), 15ml of 0.75% ropivacaine plus 0.6mcg. Kg-1 of dexmedetomidine. The Following variables were studied: onset of sensory and motor block, duration of sensory and motor block, maximal dermatomal level of analgesia. Results Dexmedetomidine group had rapid onset of action (p<0.05), prolonged duration of sensory and motor block (p<0.05), postoperative analgesia (p<0.05), and determine more intense motor block (p<0.05).There was no difference in the maximal dermatomal level of analgesia. CONCLUSION Epidural Dexmedetomidine as an adjuvant to Ropivacaine is associated with prolonged sensory and motor block, hemodynamic stability, prolonged postoperative analgesia and reduced demand for rescue analgesics when compared to plain Ropivacaine.

Keywords

• Dexmedetomidine, Ropivacaine, Epidural Block