Evaluation of Dexmedetomidine and Fentanyl as Additives to Ropivacaine for Epidural Anaesthesia and Post-Operative Analgesia in Lower Abdominal and Lower Limb Surgeries

Abstract

Background: The regional anaesthesia has lot of benefits compared to general anaesthesia for lower abdominal
and lower limb surgeries. Epidural anaesthesia is an ideal anesthetic technique for lower abdominal and lower
limb surgeries. The additives are used with Anesthetics for Early onset of action, To prolong the duration of
action, Analgesia and Improving the quality of block.
Aims and Objectives: The aim of this study was to study the clinical efficacy of Dexmedetomidine versus Fentanyl
as an additive to Ropivacaine for lumbar epidural anaesthesia and post-operative analgesia.
Materials and Methods: This study is a prospective randomised controlled study involving 90 patients
undergoing infraumbilical and lower limb surgeries who will be divided randomly into three groups Group R
(n = 30): received 18 ml of 0.5% ropivacaine for epidural anaesthesia and 10 ml of 0.2% ropivacaine boluses for
postoperative analgesia; Group RF (n = 30): received 18 ml of 0.5% ropivacaine with 25μg fentanyl for epidural
anaesthesia and 10 ml of 0.2% ropivacaine with 10 μg fentanyl boluses for postoperative analgesia; and Group RD
(n = 30): received 18 ml of 0.5% ropivacaine with 25 μg dexmedetomidine for epidural anaesthesia and 10 ml of
0.2% ropivacaine with 5 μg dexmedetomidine boluses for postoperative analgesia.
Results: Addition of additives have enhanced the onset of action, prolong duration of analgesia. Quality and
duration of epidural anaesthesia provided by ropivacaine with dexmedetomidine is more effective than fentanyl.
Better efficacy of analgesia evidenced with Dexmedetomidine than with Fentanyl.
Conclusion: It can be concluded that RD (Ropivacaine and Dexmedetomidine) when given epidurally can be a
safe and effective combination for epidural blockade in lower abdominal and lower limb surgeries.