Aim: To evaluate efficacies of dexmedetomidine and clonidine as adjuvants to ropivacaine in Epidural Anaesthesia in patients undergoing lower limb orthopaedic surgeries.

Materials and Methods: A randomized prospective study to compare the efficacies of dexmedetomidine and clonidine as adjuvants to ropivacaine in epidural anaesthesia (60 patients in each group.) Patients who were ASA physical status class I and II, Age 1860 years, either sex, Height 150170 cms and Elective lower limb orthopaedic surgeries are included in study.

Results: Present study was undertaken to compare the efficacy of epidural Clonidine or Dexmedetomidine with ropivacaine in patients undergoing elective lower limb orthopaedic surgeries. 120 ASA I and II patients of either sex, posted for elective lower limb orthopaedic surgeries were chosen for the study and the patients were divided into two groups of 60 each. Group RC received 17ml of 0.75% of ropivacaine with clonidine 30mcg. Group RD received 17ml of 0.75% of ropivacaine with dexmedetomidine 50mcg. The time of onset of sensory block was tested with bilateral pin prick method and motor block was assessed by onset of Bromage scale 3, and it was found that the onset of sensory block with Dexmedetomidine was earlier compared to Clonidine. During the procedure we observed bradycardia was more in Dexmedtomedine and hypotension was more in Clonidine Group. Bradycardia was treated successfully with vagolytic agents. Hypotension was successfully treated with vasopressors. Also few patients developed nausea and dry mouth,which were negligible. Intraoperatively sedation score was assessed using Ramsay Sedation Scale and there was higher incidence of sedation with Dexmedetomidine group. Regression of motor block to Bromage 1 was observed and the time to regression was significantly prolonged to 450.6±29.37 in the Dexmedetomidine group while it was 343.2±30.99 in the Clonidine group. Post operative analgesic requirement was low in Dexmedetomidine group compared to Clonidine group.

Conclusion: In conclusion, Dexmedetomidine (50mcg) is a better adjuvant when administered epidurally with ropivacaine 0.75% than clonidine (30mcg), as there is significantly longer duration of sensory and motor block, additional benefits of intraoperative sedation and prolonged postoperative analgesia.