Keywords : Bromage
SIMULTANEOUS USE OF DEXMEDETOMIDINE AND CLONIDINE AS POTENT ADJUVANT TO ROPIVACAINE FOR EPIDURAL ANESTHESIA IN LOWER LIMB AND LOWER ABDOMINAL SURGERIES; A COMPARATIVE STUDY
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 5, Pages 31-38
Background: The potential and duration of analgesia can be increased by adding a suitable alpha 2 adrenergic agonists as adjuvants to ropivacaine during elective lower limb surgical procedures under epidural anaesthesia. Still there is a scope for research on the effects of clonidine and dexmedetomidine as potent adjuvants in epidural local anesthetics. The aim of our study is to compare the effect of clonidine and dexmedetomidine when used as an adjuvant to epidural ropivacaine in lower abdominal and lower limb surgeries.
Materials and Methods: Patients were randomized into fourgroups Group R (n=30) patients received 10ml of 1% isobaric ropivacaine alone, Group RC (n=30) patients received 10ml of 1% isobaric ropivacaine with clonidine 1μg/kg, Group RD (n=30) patients received 10ml of 1% isobaric ropivacaine with Dexmedetomidine 1μg/kg, Group RCD (n=30) patients received 10ml of 1% isobaric ropivacaine with 0.5μg/kg Dexmedetomidine and 0.5μg/kg of clonidine. Onsetofsensory analgesia using colds wab, onset of motor blockade using Bromage scale, time to 2 dermatome regression of sensory level, time to first demand for analgesia, sedationusing Ramsaysedation scale, intra operative hemodynamic parameters and complication swere assessed.
Results: The impressive and practically applicable results were obtained in Group RCD with respect to Results: The impressive and practically applicable results were obtained in Group RCD with respect to time for onset of analgesia (29 ± 3.9 sec), maximum sensory level (T 4.12 ± 1.1), time to peak sensory level (3.49 ± 1.2 min), time for two segment sensory regression (150 ± 12.3min), time taken for sensory regression to s1 (372.5 ± 17.1), duration of analgesia (439.3 ± 64.6 min), regression to Bromage 0 (41±11.3), onset to Bromage 3 (390 ± 32.9 min) and vas score (3.10±0.50).
Conclusion: The study results strongly conclude the use of 0.5μg/kg Dexmedetomidine and 0.5μg/kg of clonidine as aneffective adjuvant to10ml of 1% isobaric ropivacaine forepiduralanesthesia in lower limb and lower abdominal surgeries.