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.