TO COMPARE THE EFFECTS OF INTRATHECALDEXMEDETOMIDINE AND FENTANYL AS ANADJUVANT TO ROPIVACAINE IN ORTHOPAEDIC LOWER LIMB SURGERIES
| Main Author: | Dr. Parmod Kumar1, Dr. Davinder Chawla*2, Dr Simrit Kaur3, Dr Tripat Kaur Bindra4,Dr. Anirudh Gupta5 & Dr. Shilpa Garg6 |
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| Format: | Article eJournal |
| Terbitan: |
, 2020
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| Subjects: | |
| Online Access: |
https://zenodo.org/record/3707725 |
Daftar Isi:
- Introduction: Spinal Anaesthesia is the preferred mode of anaesthesia for lower limb surgeries. Adjuvants to 0.5% Ropivacaine may enhance the duration and quality of analgesia. Aim: To compare the efficacy of intrathecal dexmedetomidine and fentanyl as an adjuvant to isobaric ropivacaine in orthopaedic lower limb surgeries. Materials and Methods: After informed consent,150 patients of ASA Grade I & II of age group 18-65 years of either sex, normal coagulation profile undergoing orthopaedic lower limb surgeries under spinal anaesthesia were randomly divided into 3 groups of 50 patients each. Group I: Intrathecal administration of 3 ml of 0.5% isobaric Ropivacaine with 0.5 ml Dexmedetomidine (5μg) [total of 3.5ml]. Group II: Intrathecal administration of 3 ml of 0.5% isobaric Ropivacaine with 0.5 ml Fentanyl (25μg) [total of 3.5ml]. Group III: Intrathecal administration of 3 ml of 0.5% isobaric Ropivacaine with 0.5 ml of normal saline [total of 3.5ml]. Patients were observed for onset and duration of sensory and motor blockade, haemodynamic changes, duration of analgesia, sedation and adverse effects. Results: Demographic profile was comparable in the groups. The onset of anaesthesia was shorter in Groups I and II as compared with the control Group III, but it was shorter in Group I than in Group II. The duration of sensory and motor block was prolonged in Group I and II as compared with the control Group III, but it was longer in Group I than in Group II. The duration of postoperative analgesia was prolonged in Groups I and II than in Group III, and it was prolonged in Group I than in Group II. Sedation scores were found to be statistically significantly higher in group I as compared to group II and control group III. Conclusion: Dexmedetomidine and fentanyl were effective adjuvants to ropivacaine when used in spinal anaesthesia in patients undergoing lower limb surgery. Intrathecal dexmedetomidine is associated with faster onset of sensory and motor blockade and prolonged motor and sensory block with haemodynamic stability, greater sedation and greater duration of postoperative analgesia as compared to fentanyl or alone ropivacaine