Comparative Evaluation of Levobupivacaine and Levobupivacaine with Dexmedetomidine in Infraumbilical Surgeries

Abstract

Background and Aim: Spinal anesthesia is a widely used technique providing faster onset with effective and uniformly distributed sensory and motor block. Due to decreased cardiovascular and central nervous system toxicity, levobupivacaine is a good alternative for spinal anesthesia. Present study was done to compare the effects of adding of dexmedetomidine to levobupivacaine in prolonging the analgesia produced by epidural levobupivacaine alone in patients undergoing infraumbilical surgeries. Material and Methods: A prospective study was carried out which included 100 adult patients between the age group of 20 and 65 years of physical status American Society of Anesthesiologists Classes I and II who underwent infraumbilical surgeries. Group L patients received 3 ml (15 mg) of 0.5% isobaric levobupivacaine + 0.3 ml normal saline while Group LD patients received 3 ml (15 mg) of 0.5% isobaric levobupivacaine + 0.3 ml (3 μg) dexmedetomidine. The two groups were compared with respect to the onset and duration of sensory and motor block and hemodynamic stability. Results: In Group LD, increase in VAS was observed at 210 min and the first dose of rescue analgesia was given at 5th h postoperatively. The second dose of recue analgesia was given at 12th h and the third dose was given at 21st h. Postoperative VAS scores at different time intervals were significantly lower in Group LD than Group L, thus indicating superior analgesia. The time of request of the first dose of rescue analgesia was delayed in Group LD and the difference in the two groups was highly significant (P < 0.001). Conclusion: Epidural administration of dexmedetomidine with levobupivacaine hydrochloride 0.5% results in faster onset of sensory and motor blockade compared to levobupivacaine hydrochloride 0.5% alone. Dexmedetomidine as an adjuvant to levobupivacaine hydrochloride 0.5% provides superior quality of analgesia without any significant hemodynamic instability.