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Comparison of Dexmedetomidine and Fentanyl as Adjuvants to Ropivacaine in Epidural Anaesthesia for infraumbilical Surgeries: An Observational Study

Sunitha K. Zachariah, Associate Professor, Department of Anaesthesiology, Malankara Orthodox Syrian Church Medical College, Kolenchery, Kochi, Kerala 682311, India. , Roshin K. Mathew1 , Sunitha K. Zachariah2 , Saramma P. Abraham3

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Indian Journal of Anesthesia and Analgesia 5(10):p 1687-1693, Oct 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51018.16

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Abstract

  Aims: To assess the efficacy and compare the duration of analgesia, level of sedation and side effects of 0.75% ropivacaine with  50 mcg dexmedetomidine to 0.75% ropivacaine with 50 mcg fentanyl given epidurally. Study setting: Department of Anaesthesiology, MOSC Medical College, Kolenchery. Study period: An observational descriptive study on 66 patients over a period of one year. Methods and Material: 66 patients of ASA physical status I and II of either sex in the age group of 18­65 years undergoing abdominal hysterectomy or inguinal hernioplasty were observed in the study under two groups of 33 patients in each. Epidural anaesthesia was given after a test dose of 3ml 2% lignocaine with adrenaline followed by 15 ml 0.75% ropivacaine with Group I receiving 50 mcg fentanyl as adjuvant and Group II receiving 50 mcg dexmedetomidine. Two groups were compared with respect to sensory and motor block characteristics, hemodynamic changes, level of sedation and side effects. Statistical analysis used: The data was analyzed using Chi­square test, Fisher’s exact test and Student t­test. p < 0.05 was considered to be significant and p < 0.001 as highly significant. Results: Significant prolongation of analgesia, motor blockade and two point regression time was observed in Group II as compared to group 1. A maximum sedation score of 4 was attained in 78.8% patients in Group II vs 3% in Group I, which was highly significant. Conclusions: Dexmedetomidine is a very good epidural adjuvant to ropivacaine providing prolonged duration of analgesia, excellent sedation with minimal side effects as compared to fentanyl.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51018.16

Keywords

Dexmedetomidine; Fentanyl; Epidural Anaesthesia; Lower Abdominal Surgeries; Ropivacaine

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