Comparative evaluation of ropivacaine versus dexmedetomidine and ropivacaine in epidural anesthesia in lower limb orthopaedic surgeries

Background: One of the indispensable components of spine surgeries is the relieving of post-operative pain. When used as an adjuvant in regional anaesthesia, α2 adrenergic agonists have both analgesic and sedative properties. With the addition of alpha agonist to epidural local anesthestics, the degree of pain relief increases because of their analgesic properties and augmentation of local anaesthetic effects. Hence, we comparatively evaluated the effect of ropivacaine versus dexmedetomidine and ropivacaine in epidural anaesthesia in lower limb orthopedic surgeries. Materials and methods: The present study included 200 patients in the age group of 25 to 65 years. The patients who were scheduled to undergo lower limb orthopedic surgeries under epidural anaesthesia were included for the present study. All the patients were randomly divided into two study groups; Group I and group II with 100 patients in each group. Pre-operatively pulse rate, non-invasive systolic and diastolic blood pressure (DBP) and respiratory rate was recorded. Assessment of sensory block was done was observing the loss of sensation to pin prick in the midline. Assessment of the motor block was done by analyzing the modified Bromage score. Assessment of analgesia was done by analyzing VAS score. Post-operative values of the parameters were also recorded after surgery. Adverse effects and complication like hypotension, bradycardia, headache, dry mouth, nausea and vomiting etc were noted in the first 24 hours after surgery. All the results were analyzed by SPSS software and chi square test was used for assessment of level of significance. Results: Mean age of the patients in group I and II were 40.45 and 41.23 years respectively. No significant results were obtained on comparing the mean age and mean weight of the patients. Majority of the patients in both the groups were males while rest were females. 74 % of the patients in group I belonged to ASA grade 1 while in group II, 69 percent of the patients belonged to ASA grade 2. Conclusion: For shorter surgical procedures, dexmedetomidine may be undesirable as it produces prolonged duration of motor block and sedation.