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Indian Journal of Anesthesia and Analgesia

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Comparative Study of 0.75% Ropivacaine Alone with 0.75% Ropivacaine and Dexmedetomidine Epidurally for Lower Limb & Lower Abdominal Surgery

Dr Tushar D. Bhavar, Assistant Professor, Deptt. of Anaesthesiology & Intensive Care, Rural Medical College, At/post: Loni Bk, Tal: Rahata Dist: Ahmednagar, Maharastra 413736, India. , Harpreet Babrah1 , Tushar D. Bhavar2 , Balwinder Kaur3

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Indian Journal of Anesthesia and Analgesia 4(3):p 771-776, July - September 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.36

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Abstract

Background: Neuraxial adjuvants are used with local anaesthetic agents to enhance the quality of anaesthesia. The Present study aims at comparing the efficacy & safety of adding 2- adrenergic agonist, Dexmedetomidine to 0.75% Ropivacaine with Ropivacaine alone epidurally for lower limb & lower abdominal surgery. Methodology: 50 patients (age 20-60 years, ASA grade I or II, of either sex), were randomly allocated to: Group I (n=25) epidural bolus of 20 ml(150mg) 0.75% Ropivacaine+1 ml NS, Group II (n=25) epidural bolus of 20 ml 0.75% Ropivacaine + Dexmedetomidine 1µg/kg diluted in NS Intra operative haemodynamics; onset, level & duration of sensory & motor block; level of sedation; post op analgesia & side effects were recorded & statistically analyzed using t- test, chi- square test & Mann Whitney test. Results: Groups were comparable in terms of the demographic profile, pre operative haemodynamic parameters & duration of surgery (p> 0.05). In Group II, onset of sensory block was faster in but not statistically significant(p=0.05), duration of sensory block was significantly prolonged (p<0.001), motor block onset was significantly faster (p<0.01) & duration significantly prolonged (p<0.001). Gpoup II showed significant decrease in heart rate (p<0.001), significantly higher (p<0.001) intra-op sedation scores, significantly prolonged duration of analgesia (p<0.001) & higher incidence of dry mouth as side effect (p=0.02). Conclusion: Addition of Dexmedetomidine to local anaesthetic agent Ropivacaine 0.75% epidurally as an adjuvant provides better sensory and motor block, intra-op sedation and prolonged post -op analgesia.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.36

Keywords

0.75% Ropivacaine; Dexmedetomidine; Epidural Anaesthesia; Sensory Block; Motor Block; Intra-op Sedation; Post -op Analgesia; A2 Adrenergic Agonists; Lower Limb & Lower Abdominal Surgery. 

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