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Indian Journal of Clinical Anaesthesia


A Comparative Study of Ropivacaine with Dexmedetomidine versus Ropivacaine with Fentanyl for Epidural Anaesthesia in Lower Limb Orthopaedic Surgeries


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Author Details: Subramanian R, Vijay Narayanan S, Mohamed Mubarack A, Rajalekshmi M

Volume : 3

Issue : 2

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 261

Article End Page : 270


Abstract

Background: Ropivacaine, the pure S enantiomer of propivacaine, due to its less lipophilicity than bupivacaine does not produce cardiotoxicity or neurotoxicity and causes less motor blockade. Dexmedetomidine the newer selective alpha 2 adrenergic agonist has several advantages when given through epidural route as a neuraxial adjuvant.
Aim: To compare 0.75% Inj.Ropivacaine with Inj.Fentanyl and 0.75% Inj.Ropivacaine with Inj.Dexmedetomidine epidurally for the duration of analgesia, hemodynamic changes, degree of motor blockade and occurrence of side effects.
Materials and Methods: 60 patients undergoing lower limb orthopaedic surgeries were randomized to two groups. Group RF (n=30) received 0.75% Inj.Ropivacaine 20 cc with  Inj.Fentanyl 50 mcg whereas Group RD (n=30) received 0.75% Inj.Ropivacaine 20 cc with Inj.Dexmedetomidine 50 mcg in normal saline diluted upto 1cc. Quality of sensory block, motor block, pulse rate, blood pressure, pain assessment and any adverse outcome were noted. Statistical analysis was done by student’s paired t-test for intragroup comparison and unpaired t-test for intergroup comparison and p<0.05% was taken to be significant.
Results: Dexmedetomidine fastens the onset of analgesia, prolongs the duration of analgesia thereby reducing the doses of rescue analgesics post operatively, improves the quality of motor blockade without aggravating changes in haemodynamic parameters and has less adverse effects.
Conclusion: We conclude that dexmedetomidine serves as a good neuraxial adjuvant when added to 0.75% ropivacaine in epidural anaesthesia given for lower limb orthopaedic surgery.

Keywords:
Ropivacaine, Dexmedetomidine, Fentanyl, Neuraxial adjuvant, Epidural