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ORIGINAL ARTICLE
Year : 2019  |  Volume : 33  |  Issue : 1  |  Page : 20-27

A comparative study of ropivacaine versus ropivacaine plus dexmedetomidine under epidural anesthesia in lower limb surgeries


Department of Anaesthesiology and Critical Care, Regional Institute of Medical Sciences, Imphal, Manipur, India

Correspondence Address:
Takhelmayum Hemjit Singh
Department of Anaesthesiology and Critical Care, Regional Institute of Medical Sciences, Imphal - 795 004, Manipur
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jms.jms_21_18

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Background: Adjuvants are being used with local anesthetics for prolongation of intra- and post-operative analgesia. The aim is to compare epidural ropivacaine alone and ropivacaine with dexmedetomidine on block characteristics, hemodynamics, and postoperative analgesia. Materials and Methods: Following Institutional Ethical Committee approval and written informed consent from all the patients. This study was conducted on 50 patients of American Society of Anesthesiologists Grade I and II, age between 20 and 65 years of either sex undergoing lower limb surgeries under epidural anesthesia. The patients were randomly allocated into two groups. Group R (n = 25) received 150 mg of 0.75% ropivacaine diluted to 22 ml normal saline (NS), and Group RD (n = 25) received 150 mg of 0.75% ropivacaine plus dexmedetomidine 1 μg/kg diluted to 22 ml of NS. Two groups were compared with respect to hemodynamic changes, block characteristics, time to regression at S1 dermatome and time to the first dose of rescue analgesia for 24 h, sedation score, and side effects. Data were analyzed statistically using the Chi-square test, Fisher's exact test, and Student's t-test.P < 0.05 was considered to be statistically significant andP < 0.001 as highly significant. Results: Significant difference was observed in relation to the duration of sensory block (391.68 ± 33.404 min in Group R and 529.36 ± 58.125 min in Group RD [P = 0.000]), duration of motor block (264.96 ± 30.788 min in Group R and 390.44 ± 37.994 min in Group RD [P = 0.000]), duration of postoperative analgesia (368.40 ± 52.366 min in Group R and 512.36 ± 55.815 min in Group RD [P = 0.000]), and consequently low doses of rescue analgesia in Group RD (1.96 ± 0.455) as compared to Group R (2.80 ± 0.418) (P = 0.000). Sedation score was significantly more in Group RD in the postoperative period. Conclusion: Addition of dexmedetomidine to ropivacaine provides stable hemodynamics, prolonged sensory and motor block, prolonged postoperative analgesia, and reduced demand for rescue analgesics when compared to plain ropivacaine.


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