Comparison of Dexmedetomidine Versus Fentanyl as an Adjuvent to Epidural Ropivacaine in the Patient Undergoing Lower Limb, Lower Abdomen Surgery

Abstract

Background: Ropivacaine, the pure S enantiomer of propivacaine, due to its less lipophilicity than bupivacaine does not produce cardiotoxicity or neurotoxicity and causes less motor blockade. Dexmedetomidine the newer selective alpha 2 adrenergic agonist has several advantages when given through epidural route as a neuraxial adjuvant. Aim: To compare 0.75% Inj. Ropivacaine with Inj. Fentanyl and 0.75% Inj. Ropivacaine with Inj. Dexmedetomidine epidurally for the duration of analgesia, hemodynamic changes, degree of motor blockade and occurrence of side effects. Materials and Methods: 60 patients undergoing lower limb, lower abdomen surgeries were randomized to two groups. Group RF (n=30) received 0.75% Inj. Ropivacaine 15 ml with Inj. Fentanyl 1 mcg/kg in 2 ml preparation. whereas Group RD (n=30) received 0.75% Inj. Ropivacaine 15 ml with Inj. Dexmedetomidine 1 mcg /kg in 2ml preparation. Quality of sensory block, motor block, pulse rate, blood pressure, pain assessment and any adverse outcome were noted. Results: Dexmedetomidine fastens the onset of analgesia, prolongs the duration of analgesia thereby reducing the doses of rescue analgesics post operatively, improves the quality of motor blockade without aggravating changes in haemodynamic parameters and has less adverse effects. Conclusion: We conclude that dexmedetomidine serves as a good neuraxial adjuvant when added to 0.75% ropivacaine in epidural anesthesia given for lower limb, lower abdomen surgery.