COMPARATIVE STUDY OF THE ANALGESIC EFFECT OF EPIDURAL DEXMEDETOMIDINE AND FENTANYL IN LOWER LIMB ORTHOPAEDIC SURGERIES

Abstract

INTRODUCTION : Epidural anaesthesia is one of the most commonly used procedure to provide analgesia and
anaesthesia for lower abdominal,perineal,lower limb surgeries.opiods have been used as an adjuvant to local anaesthetics
for a longer time. Recently α-2 agonists are being used as an adjuvant to provide superior analgesia with minimal side effect
AIMS: The present study aims at comparing the hemodynamic,sedative and analgesic potentiating effects of epidurally administered fentanyl
and dexmedetimidine when combined with ropivacaine.
METHODS: 60 patients of ASA1&2 undergoing lower limb orthopaedic surgeries were randomly allocated to two groups ,RD and RF, with 25
patients in each group. Group RD received 15ml of 0.75%ropivacaine with 1μg/kg of dexmedetomidine and RF received 15ml of
0.75%ropivacaine with 1μg/kg of fentanyl. Various parameters like Heart rate,blood pressure,sedation scores at every 30 minutes,onset of
sensory analgesia at T10,Time for peak sensory analgesia,onset of complete motor block,time for two segmental r egression,time for return of
motor activity to bromage1,duration of analgesia were recored in both groups and compared with the help of statistical tools like chi.square test,
paired t-test.
RESULTS: Both the study were comparable in their demographic prole,duration of surgery.onset of sensory analgesia at T10,maximum
sensory analgesia and time taken to reach that level,onset of complete motor block were earlier in RD group than RF group.Duration of analgesia
was also longer in RD group. patients in RD were much better sedated than RF group .Incidence of shivering,nausea was much higher in RF
group while incidence of dry mouth wae higher in RD group.
CONCLUSION: Thus dexmedetomidine seems to a better alternative