A Clinical Comparative Study between Fentanyl and Dexmeditomidine as an Adjuvant with 0.75% Ropivacaine in Epidural Anaesthesia for Lower Limb Orthopaedic Surgery

Abstract

Introduction: Epidural anasthesia is a common method for anaesthetic management after lower limb orthopaedic surgery. The aim is to study the anesthetic effects along with hemodynamics and adverse effects, if any when fentanyl and dexmeditomidine are used as an adjuvant to 0.75% Ropivacaine in epidural anesthesia for major lower limb orthopaedic surgery. Material and methods: The study included 100 cases classified randomly into two groups (each=50): Group RF: Patient receiving epidural anesthesia with 15 ml of 0.75% Ropivacaine and 1microgram/kg Fentanyl. Group RD: Patients receiving epidural anesthesia with 15 ml of 0.75% Ropivacaine and 1microgram/Kg of Dexmeditomidine. Results: The quality of analgesia was better with dexmedetomidine than fentanyl group (p<0.05), andthe requirement for first rescue top up was significantly latter with dexmedetomidine than fentanyl group (p<0.05).In our study while comparing the adverse effects between the two groups we did not found any significant difference between the two groups statistically. The incidence of nausea and vomiting was higher in fentanyl group while incidences of urinary retention, shivering and dry mouth was higher in dexmedetomidine group. Conclusion: Dexmedetomidine is a better adjuvant to epidural ropivacaine compared to fentanyl for epidural anaesthesia in patients undergoing lower limb orthopaedic procedures.