Role of Dexmedetomidine and Clonidine as Adjuvants With Ropivacaine in Epidural Anaesthesia- A Comparative Study

Abstract

BACKGROUND There is a need for regional anaesthesia which offers quicker onset and prolonged duration with less adverse effects to the patients. Since a long time efforts are being made to find out a better adjuvant in regional anaesthesia. This study was undertaken to compare the analgesic and sedative effects of Dexmedetomidine and Clonidine when used as a neuraxial adjuvant to ropivacaine in patients undergoing lower abdominal surgeries. MATERIALS AND METHODS A randomized, prospective, double-blind, comparative study was done in 60 patients of ASA I/II grade (American Society of Anesthesiologists), undergoing lower abdominal surgeries. Randomization was carried out and the patients were divided into two groups: ropivacaine + clonidine (Group A) and ropivacaine + dexmedetomidine (Group B), consisting of 30 in each. Group A was given admixture of 19 ml of 0.75% ropivacaine and 1 ml of 2 μg/kg of clonidine while Group B was given 19 ml of 0.75% epidural ropivacaine and 1 ml of 1.5 μg/kg of dexmedetomidine. Onset of sensory block, onset of motor block, duration of motor block, duration of analgesia, degree of sedation and side effects were observed. The data was statistically analysed using statistical package for social science (SPSS) version 17 for windows. RESULTS The study results showed that the mean time of onset of sensory and motor blockade in Group B is less when compared to Group A. The duration of motor blockade and the duration of analgesia was significantly higher in Group B compared to Group A. These differences are statistically significant. In terms of safety, the hemodynamic parameters and side effects are same in both the groups. CONCLUSION Dexmedetomidine proved to be a better neuraxial adjuvant in providing early onset of analgesia, prolonged analgesia in the postoperative period and adequate sedation when compared to Clonidine.