Objective: The aim of this study is to evaluate and compare the clinical effects of added dexmedetomidine to epidural ropivacaine 0.75% for lower limb orthopedic procedures.

Methods: 40 patients undergoing elective lower limb orthopedic procedures under epidural anesthesia were selected and divided into two groups of 20 each and assigned into Control Group (N=20): Epidural ropivacaine 0.75% 20ml (150mg)+1ml NS, Dexmedetomidine Group (N=20): Epidural ropivacaine 0.75% 20ml (150mg)+ Dexmedetomidine 1g/kg+NS to complete 1ml. Variables studied include: Block onset time, maximum dermatomal level of anesthesia, duration of sensory and motor blockade, motor block intensityassessed by bromage motor scale, sensory block assessed by sensory scale, level of sedation assessed by ramsay sedation scale, hemodynamics, duration post operative analgesiavas score

Results: Duration of analgesia was prolonged in Dex group, level of significance (p<0.05), Motor block duration was prolonged in Dex group, level of significance (p<0.05), Intensity of motor block slightly increased in dex group, but without significance (p<0.37), need for Supplemental sedation was reduced need in Dex group, level of significance (p<0.05), Duration of post-op analgesia was significantly prolonged in Dex group when compared to control group, level of significance (p<0.001).

Conclusion: There was a clear synergism between epidural dexmedetomidine and ropivacaine. Dexmedetomidine increases sensory and motor block duration during epidural anesthesia with ropivacaine, prolongs postoperative analgesia and does not cause hemodynamic instability.