A comparative study between inj. ropivacaine 0.75% and inj.ropivacaine 0.75% with inj. dexmedetomidine in lumbar epidural anesthesia for vaginal hysterectomies

Abstract

Introduction: Regional anesthesia has lots of advantages compared to general anesthesia for Vaginal hysterectomy. Intrathecal anesthesia and Epidural anaesthesia are regional anaesthesia techniques used for Vaginal Hysterectomy. Aim and Objectives: 1.To study the adjuvant effect of alpha 2 agonist DEXMEDETOMIDINE with local anesthetic (ROPIVACAINE 0.75%) in lumbar epidural anesthesia in form of onset and lasting period of sensory and motor blockade, variation in hemodynamic parameter, post-operative analgesia. Materials and Methods: The study population was randomly divided into, 25 patients in each group. 1. Group R (n=25) -20ml of 0.75% ropivacaine; 2. Group RD (n=25) -20ml of 0.75% ropivacaine + 1µg/kg of dexmedetomidine. With the patients in sitting position, epidural space was identified by hanging drop method and confirmed by loss of resistance technique to air using 18G Tuohy needle via the midline approach at either L2-3 or L3-4 inter spinous space. An epidural catheter was fixed at 3 cms inside the epidural space. Result and Interpretation: result shows the prolonged sensory and motor blockage in RD group. Onset of sensory and motor blockade is stastaticaly significant. Sedation score is higher in RD group. Difference in heamodynamic parameters were statistically not significant. Parameters and side effects between two groups. Conclusion: Dexmedetomidine given epidurally with ropivacaine produces synergistic effect of profound and prolonged motor blockade and sensory blockade with better sedation and hemodynamic stability. Ropivacaine and dexmedetomidine can be a safe and effective alternate for epidural blockade in vaginal hysterectomies. Keywords: Dexmedetomidine, Epidural anesthesia, Hemodynamic stability, Motor block, Ropivacaine, Sensory block.