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Comparative Study of Dexmedetomidine and Clonidine as Adjuvants to Isobaric Ropivacaine 0.75% for Epidural Anesthesia in Infraumbilical Surgeries

Gauri Satish Jahagirdar , Gauri Satish Jahagirdar1 , NK Nandanwankar2 , Shridhar Devidasrao Yennawar3

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Indian Journal of Anesthesia and Analgesia 7(1):p 248-256, January-February 2020. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7120.34

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Gauri Satish Jahagirdar, NK Nandanwankar, Shridhar Devidasrao Yennawar. Comparative Study of Dexmedetomidine and
Clonidine as Adjuvants to Isobaric Ropivacaine 0.75% for Epidural Anaesthesia in Infra-Umbilical Surgeries. Indian J Anesth Analg.
2020;7(1 Part -II):248-256.

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

Abstract

 

Background: Epidural anesthesia is very popular for infraumbilical surgeries. Epidural form of central neuraxial blockade techniques avoid the disadvantages associated with general anesthesia like airway
manipulations, polypharmacy and other untoward effects like postoperative nausea, vomiting and need for supplemental intravenous analgesics. Amongst different local anesthetic drugs used, Ropivacaine, being pure S-enantiomer of bupivacaine is the recently introduced long acting amide anesthetic agent is claimed to be better in its cardiovascular profile. Αlpha 2 (α2) adrenergic receptor agonists have both analgesic and sedative properties when used as an adjuvant to local anesthetic in regional anesthesia. Methodology: A double blind
prospective randomized control study conducted at tertiary health care institute to evaluate and compare the efficacy, block characteristics and postoperative analgesia of 1.5 μg/kg Dexmedetomidine in comparison to 2 μg/kg Clonidine as adjuncts to 0.75% isobaric Ropivacaine in epidural anesthesia for infraumbilical surgeries. Results: Meantime for onset of sensory and motor blockade, meantime for maximum sensory blockade and meantime for complete motor blockade was earlier with dexmedetomidine than with Clonidine as epidural adjuvant. Total duration of sensory and motor blockade was considerably longer in group receiving dexmedetomidine. Higher dermatomal level of sensory blockade, longer postoperative analgesia with better sedation was achieved by group receiving dexmedetomidine with comparative stable hemodynamics as compared to group receiving Clonidine. Conclusion: Dexmedetomidine is a better alternative to Clonidine as an adjuvant to 0.75% isobaric Ropivacaine in epidural anesthesia for providing early onset of sensory and motor blockade, desirable sedation and prolonged postoperative analgesia.

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Gauri Satish Jahagirdar, NK Nandanwankar, Shridhar Devidasrao Yennawar. Comparative Study of Dexmedetomidine and
Clonidine as Adjuvants to Isobaric Ropivacaine 0.75% for Epidural Anaesthesia in Infra-Umbilical Surgeries. Indian J Anesth Analg.
2020;7(1 Part -II):248-256.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7120.34

Keywords

Clonidine; Dexmedetomidine; Epidural anesthesia; Infraumbilical surgeries; Isobaric ropivacaine.

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