A comparative Study of Epidural Ropivacaine 0.75% Alone and Ropivacaine with Dexmedetomidine for Lower Limb Surgeries

Abstract

Background: Ropivacaine in epidural anaesthesia provides good analgesia, lesser motor blockade and cardiac stability. Addition of adjuvants like dexmedetomidine provides longer duration of analgesia, prolonged motor blockade with adequate sedation. Our study compares Ropivacaine alone and in combination with dexmedetomidine on block characteristics, postoperative analgesia and sedation. Methods: Following institutional ethical committee clearance and patients informed written consent Sixty patients (ASA I, II) aged 18 - 60 years of either sex posted for elective lower abdominal and lower limb surgeries were randomized into two groups, Group R and Group RD. The patients in group R received 19ml of 0.75% Ropivacaine with 1ml of normal saline and the patients in group RD received 19ml of 0.75% Ropivacaine with dexmedetomidine (1μg/kg) respectively. Both groups were compared with respect to onset and duration of sensory and motor blockade, intensity of motor blockade using modified bromage scale, maximum level of sensory blockade, sedation score, hemodynamic variations and adverse effects. Results: The mean onset of sensory and motor block in group R was 11.36±3.03& 16.63±2.70 minutes, in group RD was 6.80±1.30 & 12.10±1.63 minutes respectively. Duration of sensory and motor block in Group R was 199.60±23.4 & 150±17.64 minutes and in group RD was 296.30±21.12 & 235.00±17.64 minutes respectively. The patients in Group RD had rapid onset of action, significant prolongation of motor and sensory block, intense motor block, better sedation score and postoperative analgesia (p<0.05).No significant hemodynamic changes in either group. Conclusion: There is a clear synergism between dexmedetomidine and ropivacaine compared with ropivacaine in epidural anaesthesia