Study to Evaluate Usefulness of Magnesium Sulphate and Dexmedetomidine as Adjuvant to Bupivacaine for Lower Limb and Abdominal Surgeries Under Epidural Anaesthesia

Abstract

Objective: Central neuraxial blockade not only provides good anaestheti Background andcand surgical conditions but it has also advantages over general anaesthesia. To compare time of onset and duration of motor and sensory blockade, duration of analgesia, hemodynamic stability, adverse effects if any and number of rescue analgesia in first 24hours after surgery. Materials and Methods: After ethical committee permission and patient consent, study was conducted on 90 patients aged 18 to 65 years belonging to ASA- I and II undergoing lower limb and lower abdominal surgeries, were randomly divided into 3 groups. GROUP A received epidural bupivacaine 0.5 % (17 ml) + 1ml 0.9% normal saline. GROUP B received epidural Bupivacaine 0.5 %( 17 ml) + 1ml 0.5mcg per kg dexmedetomidine. GROUP C received epidural Bupivacaine 0.5 % (17 ml) + 1ml 50mg magnesium sulphate. Exclusion criteria include patient’s with bradyarrythmias, cerebrovascular diseases, neurodegenerative diseases, renal and hepatic diseases, uncontrolled hypertension, bronchial asthma, ischemic heart disease, drug and alcohol abuse and uncontrolled diabetes mellitus.The Statistical software SPSS 22.0, and R environment ver.3.2.2 were used for the analysis of the data and Microsoft word and Excel have been used to generate graphs, tables etc. Test of significance were ANOVA and chisquare test. P value <0.05 statistically significant. Results: Analgesia in postoperative period and less number of rescue analgesia was better in Group C, Duration of sensory and motor blockade was prolonged and better hemodynamic stability in Group B Conclusion: Hence addition of magnesium sulphate to epidural bupivacaine provides better post-operative analgesia and dexmedetomidine to epidural bupivacaine increases duration of motor and sensory blockade with better hemodynamic stability.