Evaluation of Fentanyl and Dexmedetomidine as Additive to ropivacaine for Epidural Anesthesia in Surgeries below T10 Level Purnendu1, Kar Soumita1,* Associate Professor and In-charge SCHS, SCHS, Symbiosis, Pune 1Graded Specialist (Anesthesia), Military Hospital, Ramgarh, Jharkhand *Corresponding Author: Dr. Purnendu, Associate Professor and In-charge SCHS, SCHS, Symbiosis, Pune, Phone: 9797595527, Email: purnendu_doc@yahoo.co.in
Online published on 4 June, 2019. Abstract Introduction Epidural anesthesia is commonly practiced for providing intra-operative surgical anesthesia. Ropivacaine is increasingly being used as an epidural agent as it has less cardiac toxicity than bupivacaine. Additives are being combined with local anesthetics to improve the quality of blockade and to accelerate the onset of blockade. This study was undertaken to compare the efficacy of fentanyl and dexmedetomidine as additive to ropivacaine for the onset, duration, and quality of epidural anesthesia in surgeries below T10 level. Objectives To evaluate the anesthetic effects of ropivacaine, ropivacaine with fentanyl, and ropivacaine with dexmedetomidine for epidural anesthesia in surgeries below T10 level. Novelty/Originality Lower doses of drug fentanyl and dexmedetomidine with ropivacaine have not been evaluated to achieve anesthetic effect. Material and Method After ethical committee clearance, 75 patients undergoing surgeries below T10 level under epidural anesthesia, divided randomly into three groups-Group 1: (R, 25): received 18ml of 0.5% ropivacaine; Group 2: (RF, 25): received 18ml of 0.5% ropivacaine with 20mcg fentanyl; Group 3: (RD, 25): received 18ml of 0.5% ropivacaine with 10mcg dexmedetomidine, into epidural space. The appropriate statistical technique will be applied on dataset. Results and Discussion The demographics and ASA grade were similar in all groups. The mean time for onset of sensory block in group R was 18.64 ± 4.41, 12.84 ± 1.84 minute in RF group and 10.76 ± 2.73 minute in RD group. The mean time of onset of motor block in group R was 24.55 ± 5.54 minute, 17.8 ± 2.53 minute in group RF and 14.8 ± 3.32 minutein RD group. The mean duration of sensory analgesia in R group was 139.77 ± 21.41 minute, in RF group was 243 ± 29.69 minute, while in RD group was 312.4 ± 30.21 minute. State of analgesia was uniform in 84% cases, partial in 4% cases and failed in 12% cases in group R but in RF and RD groups, there was no failed or partial state of analgesia. So, in RF and RD groups, state of analgesia was uniform in all 50 patients. Application Improved patient safety as ropivacaine is reported to be less cardio toxic. Conclusion Both Fentanyl and dexmedetomidine as additive to ropivacaine can provide epidural anesthesia. Epidural anesthesia achieved with dexmedetomidine is more effective than fentanyl as an additive to ropivaciane alone and duration and intensity of analgesia is also more than that due to fentanyl. Top Keywords Epidural anesthesia, Ropivacaine, Fentanyl, Dexmedetomidine. Top |