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A Comparative Study of Analgesia with Ropivacaine and Dexmedetomidine vs Ropivacaine and Fentanyl in Epidural Anesthesia in Lower Limb Surgeries

Appa Rao Mekala , Burra Ramesh Kumar1 , Appa Rao Mekala2

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Indian Journal of Anesthesia and Analgesia 6(4):p 1325-1332, July-August 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6419.37

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Burra Ramesh Kumar, Appa Rao Mekala. A Comparative Study of Analgesia with Ropivacaine and Dexmedetomidine vs Ropivacaine and Fentanyl in Epidural Anesthesia in Lower Limb Surgeries. Indian J Anesth Analg. 2019;6(4):1325-.

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Background: The popular techniques of regional anesthesia used for surgeries of lower limbs are Subarachnoid block is better term anesthesia and epidural anesthesia. Limitations of intrathecal anesthesia are short duration of analgesia, onset of sympathetic blockade rapidly and brief postoperative analgesia duration. Aim: To evaluate the synergistic effect of addition of dexmedetomidine to ropivacaine 0.75% and fentanyl to ropivacaine .75% in epidural anesthesia for surgeries of lower limbs. Materials and Methods: The study conducted in Gandhi hospital during period between December 2016 to November 2017. Institutional ethical committee clearance as well as informed consent from all patients was obtained from all patients. One hundred patients, who had various elective lower limb surgical procedures belonging to ASA class I and II were included in the study. Group RD (n = 50)–15 ml of 0.75% ropivacaine + 1.0 µg/kg of dexmedetomidine, Group RF (n=50) 15 ml of 0.75% ropivacaine and Fentanyl 1 µg/kg. Results: The mean time of onset of sensory blockade in group RD is 5.26 ± 1.49 mins and in RF 10.04 ± 2.5 mins. There is highly statistical significant difference between the groups (p = 0.000). The mean time taken for the onset of motor blockade is 11.22 ± 2.61 mins in group RD and 15.36 ± 3.28 mins in group RF There is statistical significant difference between the groups (p = 0.000). There is no statistically significant difference in the mean heart rate, mean systolic blood pressure, diastolic blood pressure and mean arterial pressure between groups at various intervals. Bradycardia and dry mouth seen only in the RD group none was in RF group. Hypotension, nausea and vomiting, tremors observed in both groups on comparision were stastically insignificant. Conclusion: Dexmedetomidine can be used as a more potent and safer alternative to Fentanyl in epidural anesthesia as a adjuvant to ropivacaine.

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Burra Ramesh Kumar, Appa Rao Mekala. A Comparative Study of Analgesia with Ropivacaine and Dexmedetomidine vs Ropivacaine and Fentanyl in Epidural Anesthesia in Lower Limb Surgeries. Indian J Anesth Analg. 2019;6(4):1325-.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6419.37

Keywords

Dexmedetomidine; Ropivacaine; Fentanyl; Epidural Anaesthesia

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