Study of additive effect of Dexmedetomidine added to epidural Ropivacaine for orthopedic lower limb procedures

Abstract

Background: The incidence of RTA is ever increasing has been associated with wide range of injuries. The present study aims to provide better anesthetic options for lower limb surgeries in order to improve intra as well as post- operative outcomes. Methodology: Total of 100 Patients of ASA Grade I and II between the age of 18 and 60 years, undergoing lower limb orthopedic surgeries, were randomly allocated to one of the two treatment group. Patients in study group A receive 17 ml of 0.75% ropivacaine and 0.5mcg per kg of Dexmedetomidine (DXM), while study group B receives 17 ml solution of 0.75% ropivacaine and 1.5mcg per kg of DXM. Bromage scale was used to measure motor blocked and grades of sedation were evaluated using Ramsay sedation score. Peri and post block characteristics as well as hemodynamic parameters were recorded. Results: The demographic profiles and the post op block characteristics of the patients in the two groups were comparable. The results of the study has shown that the addition of 0.5 mcg per kg of DXM to 17 ml solution of 0.75% ropivacaine not only prolongs the duration of analgesia but also provides desired sedation levels with peri and post-operative period hemodynamic stability during the surgical procedure. Conclusion: Titrating optimum dose of DXM as epidural adjuvant with desired duration of sensory and motor block; peri and post operative analgesia; level & duration of sedation and hemodynamic stability, it is concluded by the study that 1.5 mcg dose of DXM gives no additional benefit over 0.5 mcg/kg dose, neither to the patients nor to the surgical team.