Comparison of Dexmedetomidine V/S Propofol Used As Adjuvant with Combined Spinal Epidural Anaesthesia for Joint Replacement Surgeries
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 9
Abstract
The increased use of regional anaesthesia in recent years has led to an increased need for sedation during surgery in awake patients. Our study aim to compare the hemodynamic, duration of anaesthesia and perioperative adverse events with intravenous Dexmedetomidine and intravenous Propofol when used as an adjuvant to regional anaesthesia in joint replacement surgeries.Prospective pilot study enrolled 100 patient posted for unilateral knee replacement surgery, divided in two groups– Dexmedetomidine – group D and Propofol – group P. Patient in Group D receive intravenously Dexmedetomidine which is diluted with normal saline in a concentration of 4μg/ml and Group P receive intravenously Propofol in a concentration of 10mg/ml, firstly a loading dose and then a maintenance infusion titrated to achieve OAA/S score of 3, as per study protocol. Analysis of significance of study parameters on continuous scale by student T test,(intergroup analysis) in means between two groups and the difference in proportion by using chi square test. Significance is assessed at 5% level of significance. P value < 0.05 was considered significant.Patients in Group – D resulted to have lower heart rate in both intraoperative and postoperative periods, lower value for postoperative blood pressure, lower postoperative respiratory rate and lower postoperative OAA/S score with significant p value < 0.05. Patients in Group – P resulted to have lower intraoperative value for blood pressure, respiratory rate and OAA/S score. Additionally Dexmedetomidine resulted in better preservation of patient arousability, prolongs the effect of neuraxial blockade and have lower incidence of untoward side effect like hypotension and bradycardia. Low dose infusions of Dexmedetomidine provides an added advantage of having lesser untoward side effects and longer duration of motor block, which is desirable in joint replacement surgeries under regional anaesthesia.
Authors and Affiliations
Dr. Kuldeep Chittora, Dr. Ritu Sharma, Dr. Rajeev Lochan Tiwari
Keywords
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