A COMPARATIVE STUDY OF EPIDURAL ROPIVACAINE (0.75%) PLUS CLONIDINE WITH ROPIVACAINE (0.75%) PLUS DEXMEDETOMIDINE FOR LOWER ABDOMINAL AND LOWER LIMB SURGERIES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 54
Abstract
BACKGROUND Epidural anaesthesia is one of the most common regional anaesthetic techniques used for lower abdominal and lower limb surgeries. Epidural anaesthesia provides effective surgical anaesthesia and can also achieve the extended duration of surgical needs, provides prolonged postoperative analgesia, lowers the incidence of haemodynamic changes. The quality and duration of analgesia is improved when a local anaesthetic is combined with alpha-2 adrenergic agonist as neuraxial adjuvants. The aim of our study is to compare the effect of Clonidine and Dexmedetomidine when used as an adjuvant to epidural Ropivacaine in lower abdominal and lower limb surgeries. MATERIALS AND METHODS A prospective randomised double blinded study was conducted in 60 patients of either sex between the ages of 20 and 60 years of (American Society of Anaesthesiologists) ASA I/II grade who underwent lower abdominal and lower limb surgeries. The patients were randomly allocated into two groups; Ropivacaine + Clonidine (RC) and Ropivacaine + Dexmedetomidine (RD) comprising of 30 patients each. Group RC received 15 mL of Ropivacaine (0.75%) with 75 µg Clonidine and group RD received 15 mL of Ropivacaine (0.75%) with Dexmedetomidine 50 µg epidurally. Onset of sensory analgesia using bilateral pin-prick method, onset of motor blockade using Bromage scale, time to two dermatome regression of sensory level, time to first demand for analgesia, intraoperative haemodynamic parameters and complications were observed. Statistical analysis was done by chi-square test for qualitative data and unpaired student t-test for quantitative data using statistical package for social science (SPSS) version 19 for windows and value of p<0.05 was considered significant and p<0.001 as highly significant. RESULTS The demographic profile and cardiorespiratory parameters were comparable and statistically non-significant in both the groups. The side effect profile was also comparable with a little higher incidence of nausea and dry mouth in both the groups which was again a non-significant entity (P>0.05). Dexmedetomidine group (RD) had rapid onset of sensory and motor blockade (p<0.05), prolonged duration of sensory and motor block (p<0.05) and postoperative analgesia (p<0.05). CONCLUSION Dexmedetomidine is a better neuraxial adjuvant to epidural Ropivacaine compared to clonidine for providing early onset and long duration of sensory analgesia and motor blockade, longer post-operative analgesia.
Authors and Affiliations
Kumar Shailesh, Dipak L. Raval, Aarti Kumari, Sudha Kumar Dhas
Keywords
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- EP ID EP225795
- DOI 10.14260/Jemds/2017/881
- Views 63
- Downloads 0
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