COMPARISON OF EFFECT OF FENTANYL AND DEXMEDETOMIDINE ON POST-OPERATIVE ANALGESIA AND HAEMODYNAMICS WHEN ADDED TO BUPIVACAINE 0.5% IN EPIDURAL BLOCK FOR PELVIC AND LOWER LIMB ORTHOPAEDIC SURGERIES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 57
Abstract
BACKGROUND This study was designed to investigate whether the addition of fentanyl or dexmedetomidine to bupivacaine for epidural block would prolong postoperative pain relief and reduce the need for additional analgesics block in pelvic and lower limb orthopaedic surgeries. OBJECTIVE Comparison of effect of 1.0 mcg/kg of Dexmedetomidine and Fentanyl 2 mcg/kg on post-operative analgesia and haemodynamic when added to bupivacaine 0.5% in epidural block for pelvic and lower limb orthopaedic surgeries. MATERIAL AND METHOD In our randomized control trial, total 75 adult ASA class I and II patients undergoing lower limb orthopaedic and pelvic surgeries were given epidural block and studied for addition of dexmedetomidine and fentanyl on intraoperative haemodynamic and post-operative analgesia. Patients received 0.5% bupivacaine 20 mL in one group and we added Dexmedetomidine 1.0 mcg/kg and Fentanyl 2 mcg/kg in the other 2 groups respectively. All the patients were monitored for onset of effect, intraoperative haemodynamic, post-operative analgesia and complications. RESULT The mean time for onset of sensory block was significantly rapid in dexmedetomidine and fentanyl group as compared to bupivacaine group. The offset time of sensory and motor block was prolonged in dexmedetomidine group in comparison to control and fentanyl group. Addition of Dexmedetomidine substantially prolongs postoperative pain free period than Fentanyl and Bupivacaine. CONCLUSION Addition of Dexmedetomidine, an alpha-2 agonist to local anaesthetic solution for conduct of lumbar epidural block in the dose range of 1.0 mcg/kg substantially prolongs postoperative pain free period without altering block characteristics offered by Bupivacaine and is a better adjuvant than fentanyl, an opioid, but it also prolongs the motor blockade which may hamper early mobilization of patients
Authors and Affiliations
Vivek , Krishna , Deepak
Keywords
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- EP ID EP128618
- DOI 10.14260/jemds/2016/894
- Views 94
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