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Evaluation of Dexmedetomidine as an Additive to Ropivacaine for Popliteal Approach for Sciatic Nerve Block for Foot Surgeries

Pallavi Ahluwalia, Professor, Department of Anaesthesia, Teerthanker Mahaveer Medical College, Moradabad­244001, U.P., India. , Pallavi Ahluwalia1 , Payal Jain2 , Amit Ahluwalia3

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Indian Journal of Anesthesia and Analgesia 5(11):p 1872-1879, November-December 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51118.15

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Abstract

  Introduction: Peripheral nerve blocks are used in varieties of surgical and diagnostic procedures. Various methods or approaches have been tried to prolong the duration of nerve blocks. Dexmedetomidine acts selectively on alpha­2 adrenergic receptor agonist and can be a promising adjuvant to local anaesthetics. Our study evaluates the clinical efficacy of dexmedetomidine added to Ropivacaine for sciatic nerve block. Material and Methods: Patients undergoing foot surgeries were divided randomly into two groups. Group RS (n = 30): received 19.5 ml of 0.75% Ropivacaine and 0.5 ml saline for sciatic nerve block via popliteal approach and Group RD (n = 30): received 19.5 ml of 0.75% Ropivacaine with 0.5 ml (50 mg) of dexmedetomidine. Result: The onset time of sensory block (mean) in minutes was 8.64±2.4 in RS Group, 5.78±2.7 in RD Group (p < 0.001). The mean time for onset of motor block, in minutes, was 10.42±3.6 in RS Group, 8.78±1.7 in RD Group (p < 0.001). The difference in regards to duration of sensory and motor block was statistically significant, with RD Group faring better than RS Group. The mean time to rescue analgesia, in minutes, was 339.8±29.31 in Group RS and 512.43±30.92 in Group RD (p < 0.001). The quality of anaesthesia was better and sedation scores were more in group RD versus group RS. Conclusion: The overall quality of anesthesia achieved with 50 g dexmedetomidine as an additive to 0.75% Ropivacaine is more effective in terms of duration and intensity of analgesia in comparison to 0.75% Ropivacaine alone. 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51118.15

Keywords

Adrenergic 2­Receptor Agonists; Ultrasonography; Dexmedetomidine; Sciatic Nerve.

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