Comparative Analysis of the Efficacy of Epidural Dexmedetomidine and Clonidine with Bupivacaine in Patients Undergoing Infraumbilical Surgeries

Abstract

Introduction: Pain was defined by Mountcastle in the year 1968 as “that sensory experience evoked by stimuli that injures”. It is a subjective feeling and failure to relieve pain in any procedure cannot be accepted, both ethically and morally, and adequate pain relief must be treated as basic human right. Pain relief both in peri-operative and post-operative period is the crux of anaesthesia. The aim of the study was to evaluate the efficacy of epidural Dexmedetomidine and Clonidine as an adjuvant to Bupivacaine in patients undergoing infraumbilical surgeries. Material and Methods: Seventy (70) patients aged 20-60 years (ASA I-II) undergoing infraumbilical surgery were randomly allocated to two groupsGroup BD receiving epidurally 15ml Bupivacaine (0.5%) + Dexmedetomidine (1mg/kg) and Group BC receiving 15ml Bupivacaine (0.5%) + Clonidine (1mg/kg). After securing I/V line, infusion started with R/L and under strict aseptic condition, patients were administered epidural block via 18G Tuohy needle in the sitting or lateral position at L3-L4 intervertebral space. Results: We observed that the time taken for the onset of sensory block at T10 level, time for sensory block upto T6 and the time taken for maximum motor block is less in Group BD compared to Group BC. Regarding the post-operative block, the time to sensory two segment regression, time to sensory regression to S1, time for recovery of motor block and time to first rescue analgesia were more in Group BD compared to Group BC. And the difference between the two groups were significant (p<0.001). Conclusion: On the basis of the findings of our present clinical study, we can come to conclusion that Dexmedetomidine is more effective epidural adjuvant compared to Clonidine in patients undergoing infraumbilical surgery.