A Comparative Study of Anaesthetic Efficacy of 0.75% Ropivacaine and 0.75% Ropivacaine with Dexmedetomidine in Epidural Anaesthesia for Inguinal Hernia Repair
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2019, Vol 6, Issue 1
Abstract
Introduction: Ropivacaine is nowadays replacing bupivacaine as the drug of choice in epidural anesthesia It has a high therapeutic index in a study conducted in humans.it is less neurotoxic and cardiotoxic than bupivacaine. One among the disadvantage in adding opioids is respiratory depression. To overcome this many studies emphasized adding clonidine with the local anesthetic drugas epidural anesthesia. This provides a marked reduction in the need for using hypnotics, inhaled opioids analgesics for treating postoperative pain. Aim of the Study: The clinical characteristics of epidural anesthesia performed with 0.75% ropivacaine and to evaluate the synergistic effect between dexmedetomidine and 0.75% ropivacaine in epidural anesthesia. Materials and Methods: After approval of the study by our institutional ethics committee, the study was conducted on 50 patients of both sexes, aged between 25 to 55 years and physical status according to the American Society of Anesthesiologists (ASA) Ior II, undergoin gelective inguinal hernia repair surgeries. Lumbar epidural anesthesia was performed to all the patients. Weight was ranging from 55-70 kg and height ranging from 150-172 cm. Group I: (n = 25): Patients received 1 ml of 0.9% normal saline + 19 ml of 0.75% hyperbaric ropivacaine. Group II: (n = 25): Patients received dexmedetomidine 1 µg /Kg + 0.9% normal saline so that total volume was completed to 1 ml + o.75% hyperbaric ropivacaine 19 ml was given. Results: The mean time required for the onset of sensory block Group –R 9.0800, Group-R Dex 8.0900 in both groups was not statistically significant. Group RDex achieved complete motor blockade (Bromage scale) much earlier than group R 22.8400 and Group-R Dex 19.0000 there was statistically significant difference noticed in between these two groups (‘p’ value < 0.05). Out of 25 patients, there are 2 in group-R and group- R Dex 5 had bradycardia with the heart rate of <55 beats /minute and it as treated with 0.3 mg of atropine. The sedation score between R and R Dex groups reveals a statistically significant difference (P<0.001). The side effects in both the groups were comparable; no statistical difference was noticed between the group-R and RDex. Conclusion: Present study obviously reveals that an apparent synergism between the two drugs namely dexmedetomidine and ropivacaine without any additional morbidity, which has been proved statistically significant using quantitative and qualitative analysis.
Authors and Affiliations
Shakeela Begum
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- EP ID EP601254
- DOI 10.21088/ijaa.2349.8471.6119.49
- Views 242
- Downloads 0
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