A comparative study of epidural 0.5% isobaric levobupivacaine and epidural 0.5% isobaric levobupivacaine with dexmedetomidine for patients undergoing elective infraumbilical and lower limb surgeries
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 10, Issue 2
Abstract
Background: Regional anaesthesia is the most commonly used technique for lower abdominal and lower limb surgeries as it is very economical and easy to administer. A number of adjuvants, such as opioids and alpha 2 agonists, have been studied to prolong the effect of regional anaesthesia which is of utmost importance for post operative pain relief. Also the quest for searching newer and safer anaesthetic agents has always been one of the primary needs in regional anaesthesia. Keeping these factors in mind, it was proposed to study the S (−)-enantiomer of bupivacaine, levobupivacaine and its effects when added with dexmedetomidine. Aim of the Study: The aim of the present study is to evaluate the effects of addition of fixed dose of Dexmedetomidine 50 micrograms to epidural 0.5% isobaric Levobupivacaine solution on the time of onset of sensory blockade to T10 level, Maximum level of sensory blockade and time taken to achieve that level, Onset of motor blockade, Degree of motor blockade achieved, time taken to achieve the same, Haemodynamic changes, Side effects, Intraoperative sedation scores, Duration of analgesia, sensory and motor blockade. Materials and Methods: Sixty patients of either sex belonging to ASA I and II in the age group of 25-45 years scheduled for infraumbilical and lower limb surgeries were randomly divided into 2 groups (30 each) Group A received 0.5% isobaric levobupivacaine 20 ml epidurally with 0.5 ml distilled water and Group B 0.5% isobaric levobupivacaine 20 ml plus 0.5 ml dexmedetomidine 50 micrograms. Results: Maximal sensory level(T4), maximal motor blockade (Bromage 3) were achieved with the addition of dexmedetomidine(50 micrograms). Duration of analgesia, sensory and motor blockade were prolonged when levobupivacaine is combined with dexmedetomidine epidurally. Conclusion: The use of dexmedetomidine 50 micrograms as an adjuvant to levobupivacaine in epidural/spinal anesthesia seems to be a good alternative to the use of opioids with minimal side effects.
Authors and Affiliations
Mangal Swathi V, Suganthi C, Murugan T
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