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A Comparative Study of 0.5% Levobupivacaine alone with 0.5% Levobupivacaine and Dexmedetomidine Epidurally for Major Orthopedic Surgeries


Affiliations
1 Department of Anaesthesia, Government Medical College, Rajindra Hospital, Patiala, Punjab, India
 

Background and Aims: Alpha (α )-2 agonists as epidural adjunct to Local Anaesthetics (LA) are being increasingly used for the purpose of faster onset of sensory blockade and prolonged duration of analgesia. The present study aims at comparing the hemodynamic, sedative, and analgesia potentiating effects of epidurally administered dexmedetomidine combined with levobupivacaine versus levobupivacaine alone.

Material and Methods: A total of 100 patients of either sex, aged between 20-60 years, ASA physical status I and II admitted for lower limb orthopaedic surgeries were enrolled into the present study. Patients were randomly divided into two groups: Levobupivacaine (Group L) and levobupivacaine + Dexmedetomidine (Group LD), comprising of 50 patients each. Injection levobupivacaine, 15 ml of 0.5% (isobaric), was administered epidurally in both the groups with addition of 1 μg/kg of dexmedetomidine in LD group. Besides cardio-respiratory parameters and sedation scores, various block characteristics were also observed which included time to onset of analgesia, maximum sensory analgesic level, time to complete motor blockade and the time to two segmental dermatomal regressions. At the end of study, data was compiled systematically and analysed using ANOVA. Value of P<0.05 was considered significant and P<0.001 as highly significant.

Results: The demographic profile of patients was comparable in both the groups. Onset of sensory analgesia (in minutes) in group L and LD was 21.42±3.38 versus 9.26±1.82. Establishment of complete motor blockade 18.02±2.73 versus 27.90±3.81 was significantly earlier. Postoperative analgesia was prolonged significantly 344.08 ±24.40 minutes and sedation scores were highly significant on statistical comparison (P<0.001) in the LD group.

Conclusions: Dexmedetomidine is a good epidural adjuvant to levobupivacaine as it provides stable hemodynamics, early onset of sensory anaesthesia, prolonged post-operative analgesia and good sedation levels.


Keywords

Dexmedetomidine, Epidural Anaesthesia, Levobupivacaine, Lower Limb Surgery.
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  • A Comparative Study of 0.5% Levobupivacaine alone with 0.5% Levobupivacaine and Dexmedetomidine Epidurally for Major Orthopedic Surgeries

Abstract Views: 290  |  PDF Views: 89

Authors

Kiran D. Marothia
Department of Anaesthesia, Government Medical College, Rajindra Hospital, Patiala, Punjab, India
Balwinder Kaur
Department of Anaesthesia, Government Medical College, Rajindra Hospital, Patiala, Punjab, India
Parmod Kumar
Department of Anaesthesia, Government Medical College, Rajindra Hospital, Patiala, Punjab, India
J. P. S. Bhupal
Department of Anaesthesia, Government Medical College, Rajindra Hospital, Patiala, Punjab, India

Abstract


Background and Aims: Alpha (α )-2 agonists as epidural adjunct to Local Anaesthetics (LA) are being increasingly used for the purpose of faster onset of sensory blockade and prolonged duration of analgesia. The present study aims at comparing the hemodynamic, sedative, and analgesia potentiating effects of epidurally administered dexmedetomidine combined with levobupivacaine versus levobupivacaine alone.

Material and Methods: A total of 100 patients of either sex, aged between 20-60 years, ASA physical status I and II admitted for lower limb orthopaedic surgeries were enrolled into the present study. Patients were randomly divided into two groups: Levobupivacaine (Group L) and levobupivacaine + Dexmedetomidine (Group LD), comprising of 50 patients each. Injection levobupivacaine, 15 ml of 0.5% (isobaric), was administered epidurally in both the groups with addition of 1 μg/kg of dexmedetomidine in LD group. Besides cardio-respiratory parameters and sedation scores, various block characteristics were also observed which included time to onset of analgesia, maximum sensory analgesic level, time to complete motor blockade and the time to two segmental dermatomal regressions. At the end of study, data was compiled systematically and analysed using ANOVA. Value of P<0.05 was considered significant and P<0.001 as highly significant.

Results: The demographic profile of patients was comparable in both the groups. Onset of sensory analgesia (in minutes) in group L and LD was 21.42±3.38 versus 9.26±1.82. Establishment of complete motor blockade 18.02±2.73 versus 27.90±3.81 was significantly earlier. Postoperative analgesia was prolonged significantly 344.08 ±24.40 minutes and sedation scores were highly significant on statistical comparison (P<0.001) in the LD group.

Conclusions: Dexmedetomidine is a good epidural adjuvant to levobupivacaine as it provides stable hemodynamics, early onset of sensory anaesthesia, prolonged post-operative analgesia and good sedation levels.


Keywords


Dexmedetomidine, Epidural Anaesthesia, Levobupivacaine, Lower Limb Surgery.

References