Comparative study of dexmedetomidine and fentanyl as an adjuvant to bupivacaine for epidural Anaesthesia in lower limb Orthopedic surgeries

Abstract

Background: The addition of adjuvants to local anaesthetics causes an improvement in the quality and duration of analgesia which is a pivotal component for both intra operative and post-operative haemodynamic stability. Our study aims to compare the effect of Dexmedetomidine and fentanyl as an adjuvant to epidural bupivacaine in lower limb orthopedic surgeries. Methods: 60 patients of ASA grade l and ll were randomized into two groups: Gr BD: received 15 ml of 0.75% bupivacaine with 1µg/kg dexmedetomidine and Gr BF: received 15 ml of 0.75% bupivacaine with 1µg/kg fentanyl. Onset of sensory analgesia using cold swab or pinprick, onset of motor blockade using Bromage scale, intra operative hemodynamic variations and complications, time of first demand for analgesia, sedation using Ramsay sedation scale were studied. Results: The onset (BD-8.75 ± 2.0, BF-10.85 ± 1.8) and duration of sensory blockade (BD-335 ± 31.5, BF-268 ± 36) was found to be better in BD group, incidences of sedation and hypotention were found to be more in the dexmedetomidine group. Conclusion: Dexmedetomidine as an adjuvant in a dose of 1 µg/kg is an effective adjuvant to bupivacaine for epidural anesthesia, as compared to fentanyl.