Dexmedetomidine And Fentanyl For Epidural Anesthesia With 0.5% Levobupivacaine For Lower Limb Orthopedic Surgey – A Comparitive Evaluation

Abstract

Background: Addition of adjuvants to local anesthetic enhance the quality and duration of epidural anesthesia. The present study aimed to compare the hemodynamic, sedative, anesthetic and analgesic potentiating effects of Dexmedetomidine and Fentanylwith 0.5% Levobupivacaine for lower limb orthopedic surgery. Method: 60 consented patients of both gender aged 25-60, ASA I and II physical status who underwent lower limb orthopedic surgery were randomly divided into two groups. Patients received epidural study solution of 0.5% Levobupivacaine 14ml either with 25mcg DexmedetomidineGroup- D or 50 mcg Fentanyl Group- F. The total volume was kept 15ml.Time of onset, level of sensory and motor blockade and duration of analgesia were assessed. Perioperative sedation score, hemodynamic parameters, respiratory efficiency and side effects were also noted. Data obtained was compiled with SPSS 16.0 with student t- test and Chi-squaretest. Value of p<0.05 was considered significant. Result: The demographic profile was comparable between groups. Onset of sensory blockade andtime to achieve complete motor blockade were significantly earlier and duration of motor blockade and analgesia were prolonged significantly in groupD (P<0.001). Sedation scorewas better in Group D and highly significant statistically (P<0.001). Hemodynamic changes were comparable between two groups. Incidence of nausea, vomiting, pruritus, and shivering werehigh in Group F and dry mouth was high in Group D. Conclusion: Dexmedetomidine was better than Fentanyl as an epidural adjuvant for providing early onset of sensory blockade, prolonged motor blockade and post-operative analgesia and better sedation without any major side effects.