Epidural ropivacaine with fentanyl versus ropivacaine with dexmedetomidine- A comparative prospective randomized control study in lower abdominal surgeries

Abstract

Background: Epidural neuraxial blockade reduces frequent dosing of analgesics when especially an additive is added epidurally. Epidural
ropivacaine provides lesses motor blockade and for lesser duration but it is less cardiac toxic. This prospective study is about comparing
advantages and disadvantages of an epidurally given synthetic opioid, fentanyl or α2- agonist, dexmedetomidine when added with local
anaesthetics ropivacaine in lower abdominal surgeries. Aim: To determine and compare the efficacy of epidural ropivacaine and fentanyl with
epidural ropivacaine and dexmedetomidine. Materials and methods: This is a comparative prospective randomized control study, approved by
institutional ethical committee. An individual informed consent was taken from all patients. All patients belonging to ASA grade 1 and 2,
between age group of 18 to 50 years undergoing lower abdominal surgeries. Patients with contraindication for epidural anaesthesia, BMI >30
were excluded. Total 120 patients undergoing lower abdominal surgeries were divided into Group I (60 Patients, 0.75% Ropivacaine 18ml and
Fentanyl 25μg epidurally), groupII (60 Patients0.75% Ropivacaine 18ml and Dexmedetomidine 50μg epidurally). Discussion: epidural block
has advantage of extending analgesia to the postoperative period and has better hemodynamic profile.In this study we are comparing the
adjuvants fentanyl and dexmedetomidine when administered with ropivacaine for epidural anaesthesia for infra umbilical surgeries. Conclusion:
Addition of dexmedetomidine as an adjuvant to ropivacaine is better than fentanyl in providing sensory block, motor block and the analgesic
effect with side effects that are easily manageable.