A Comparative Study of Analgesia with Ropivacaine and Dexmedetomidine vs Ropivacaine and Fentanyl in Epidural Anesthesia in Lower Limb Surgeries
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2019, Vol 6, Issue 4
Abstract
Background: The popular techniques of regional anesthesia used for surgeries of lower limbs are Subarachnoid block is better term anesthesia and epidural anesthesia. Limitations of intrathecal anesthesia are short duration of analgesia, onset of sympathetic blockade rapidly and brief postoperative analgesia duration. Aim: To evaluate the synergistic effect of addition of dexmedetomidine to ropivacaine 0.75% and fentanyl to ropivacaine .75% in epidural anesthesia for surgeries of lower limbs. Materials and Methods: The study conducted in Gandhi hospital during period between December 2016 to November 2017. Institutional ethical committee clearance as well as informed consent from all patients was obtained from all patients. One hundred patients, who had various elective lower limb surgical procedures belonging to ASA class I and II were included in the study. Group RD (n = 50)–15 ml of 0.75% ropivacaine + 1.0 µg/kg of dexmedetomidine, Group RF (n=50) 15 ml of 0.75% ropivacaine and Fentanyl 1 µg/kg. Results: The mean time of onset of sensory blockade in group RD is 5.26 ± 1.49 mins and in RF 10.04 ± 2.5 mins. There is highly statistical significant difference between the groups (p = 0.000). The mean time taken for the onset of motor blockade is 11.22 ± 2.61 mins in group RD and 15.36 ± 3.28 mins in group RF There is statistical significant difference between the groups (p = 0.000). There is no statistically significant difference in the mean heart rate, mean systolic blood pressure, diastolic blood pressure and mean arterial pressure between groups at various intervals. Bradycardia and dry mouth seen only in the RD group none was in RF group. Hypotension, nausea and vomiting, tremors observed in both groups on comparision were stastically insignificant. Conclusion: Dexmedetomidine can be used as a more potent and safer alternative to Fentanyl in epidural anesthesia as a adjuvant to ropivacaine.
Authors and Affiliations
Burra Ramesh Kumar
Intrathecal Hyperbaric Bupivacaine and Isobaric Levobupivacaine for Spinal Anaesthesia: Block Characteristics and Clinical Effects
Introduction: Bupivacaine (0.5% heavy) is used to administer subarachnoid block but carries an increased risk of cardiac and central nervous system toxicity if inadvertently injected intravascularly. Levobupivacaine is S...
Comparison of Paravertebral Block and Interpleural Block in Patients Undergoing Breast Surgery Under General Anaesthesia
Background and Aims: Paravertebral and interpleural blocks are indicated for providing intraoperative and postoperative analgesia in unilateral surgeries of the chest and abdomen. The aim of this study was to evaluate th...
A Comparative Study of Post Operative Side Effects between Spinal Bupivacaine Plus Buprenorphine and Combined Femoral and Sciatic Nerve Block Plus Spinal Bupivacaine Used for Analgesia
Aim and objective: The aim of this study was to compare postoperative side effects produced by spinal bupivacaine plus buprenorphine with femoral and sciatic nerve blocks plus spinal bupivacaine. Settings and Design: Ran...
A Randomized Controlled Study to Compare the Efficacy of Ropivacaine and Bupivacaine in Spinal Anesthesia in Children
Aim: To evaluate the efficacy of Ropivacaine and Bupivacaine in spinal anaesthesia in children for infraumblical surgeries as regional anaesthesia in children and ambulatory setup is gaining popularity. Materials and Me...
Comparision of Nitroglycerine and Clonidine to Attenuate the Pressor Response to Laryngoscopy and Intubation
This study was carried out to compare the effectiveness of I.V. nitroglycerine and clonidine for controlling the pressor response to laryngoscopy and endotracheal intubaltion during general anaesthesia. This study was do...