A COMPARATIVE STUDY OF DEXMEDETOMIDINE AND FENTANYL AS AN ADJUVANT TO EPIDURAL BUPIVACAINE IN INFRAUMBILICAL SURGERIES

Abstract

Background Early postoperative mobilization, minimal pain and recovery are desirable features of modern anaesthesia post surgery. Epidural anaesthesia is most commonly used for providing postoperative analgesia. To achieve this, larger volume of local anaesthetics are used epidurally which increased the possibility of local anaesthetic toxicity. To reduce the local anaesthetic toxicity adjuvants to epidural infusion such as opioids, α2 agonists, benzodiazipines are added. Present study is done to evaluate the efcacy of dexmed Objective: etomidine and fentanyl for studying the duration of postoperative analgesia and sedation. Methodology: 80 patients of ASA grade I and II posted for elective lower abdominal and lower limb surgeries were selected for our study.They were premedicated with table tranitidine 150mg and tablet alprazolam 0.25mg night prior to surgery. Baseline parameters of vitals were recorded. Patients were preloaded with Ringer lactate solution of 15ml/kg . Under strict aseptic precautions, epidural catheter was introduced at L3-L4 space and test dose was given using 3ml of 2% Lignocaine with adrenaline followed by SAB given with injection hyperbaric bupivacaine 0.5% 15mg. After 90 min of subarachnoid block they were injected either 25ml of 0.125% bupivacaine with 0.5μg/kg dexmedetomidine or 25 ml 0.125% bupivacaine with 1μg/kg fentanyl epidurally at a rate of 5ml/hour using syringe pump. Rescue analgesia was supplemented with injection morphine 0.1mg/kg through intravenous route. Duration of analgesia , hemodynamic parameters and sedation score were noted. Analgesic effect was noted by visual analogue scale. Patients were observed for side effects Duration of postoperative analgesia, hemodynamic stability Results: and sedation were better with dexmedetomidine than fentanyl. Dexmedetomidine is a better adjuvant to epidural b Conclusion: upivacaine than fentanyl in terms of prolonged duration of analgesia with better sedation and hemodynamic parameters