Epinephrine as Epidural Adjuvant to Bupivacaine and Fentanyl in Elective Orthopedic Surgeries
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2014, Vol 2, Issue 5
Abstract
Epinephrine when used as an epidural adjuvant to thoracic epidural anesthesia was found to prolong the duration of anesthesia and also enhance the motor blockade. When it was used as adjuvant in labour analgesia it was found to have disadvantages of having denser motor block. The vasoconstriction and α2 agonism was the reason hypothesized to the above action of the epidural Epinephrine. Hence our study was designed to study the effects of Epinephrine in epidural anesthesia with Bupivacaine and Fentanyl in patients undergoing elective orthopedic surgeries in supine position. Study involved 40 patients, of whom 20 patients received 0.5% Bupivacaine with 1 µg/ml of Fentanyl and 5 µg/ml of Epinephrine and 20 of them, received 0.5% Bupivacaine with 1 µg/ml of Fentanyl. We compared the two groups for the onset of the sensory and motor block, degree of motor block, duration of analgesia and hemodynamics. From our study we could conclude that addition of Epinephrine at 5 µg/ml to 0.5% Bupivacaine and 1 µg/ml of Fentanyl resulted in enhancement of the onset of block, with higher degree of motor blockade. But the duration of analgesia was not enhanced by addition of Epinephrine. Keywords: Epinephrine, Bupivacaine, Fentanyl, Epidural anesthesia
Authors and Affiliations
Darshan M. S, Sri Devi S, Karthik A, Jeyakumar V, Nagasunitha C. H
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