Comparative Evaluation of the Efficacy and Safety of Fentanyl and Dexmedetomidine as Adjuvants to Levobupivacaine in Epidural Anaesthesia in Patients Undergoing Hip and Lower Limb Surgeries
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 2
Abstract
Introduction: Epidural anaesthesia is a central neuraxial block with many applications ranging from analgesia with minimal motor block to dense anaesthesia with full motor block. The present study was aimed to compare the haemodynamic, sedative and analgesia potentiating effects of dexmedetomidine versus fentanyl as adjuvants to 0.5% Levobupivacaine in epidural anaesthesia in patients undergoing hip or lower limb surgeries. Methods: 90 patients of either sex ranging in the age group between 18 to 60 years belonging to ASA grade I & II, scheduled for hip and lower limb surgeries were selected. Patients were randomly allocated into three groups of 30 each. Group L was the control group and patients in this group received epidural levobupivacaine (0.5%) 19 ml + Saline (0.9%) 1ml, patiens in group LD received epidural levobupivacaine (0.5%) 19ml + Dexmedetomidine (50μg) 1ml and patients in group LF received epidural levobupivacaine (0.5%) 19ml + fentanyl (50μg) 1ml. Patients were evaluated for sensory and motor characteristics of the block (onset and duration), sedation, duration of analgesia and side effects. Results: It was observed that onset of sensory block was faster in LD group as compared to Group LF and Group L. The highest level of Sensory block obtained was T5-T6 in 83.33% patients of LD group,T7-T8 in 63.33% patients in LF group and T9 - T10 in 43-33 % patients in L group. Mean time to achieve highest level of sensory block and maximum Bromage Score was achieved in significantly shorter time in LD group as compared LF and L groups. Segmental regression to S1 and complete motor regression to Bromage O was longer in group LD as compared to Group LF and L Conclusion: We concluded that dexmedetomidine is a better adjuvant than fentanyl in epidural anesthesia as it produces early onset and more prolonged motor and sensory block, better sedation, prolonged analgesia and good patient satisfaction.
Authors and Affiliations
Anita Vig, Ajay Gupta, Ankita Atri, Smriti Gulati
Keywords
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- EP ID EP539153
- DOI 10.21276/ijmrp.2018.4.2.047
- Views 82
- Downloads 0
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