DEXMEDETOMIDINE AS ADJUVANT TO EPIDURAL BUPIVACAINE FOR LAPAROTOMIES- A DOUBLE BLIND PILOT STUDY.

Dr. Asish Karthik* MD, FCA, FIPM, Dr. Shamshad Beegam T. S., MD, Dr. Shuaib Bin Aboobacker, MD, Dr. Sruthi Ramachandran MBBS, Dr. K. N. Radhakrishnan

ABSTRACT

Background and Aim: Epidural anaesthesia is widely practiced for laparotomy. Adjuvant to local anaesthetics improves the quality and duration of this route and dexmedetomidine can be a useful adjuvant. We undertook a double blind study comparing 12 ml of 0.5% bupivacaine with a combination of same dose bupivacaine and 1 mcg per kilogram of dexmedetomidine as adjuvant, administered epiduraly, in laparotomy. Material and Methods: The participants of the study were randomly allocated in to two groups of 30 each; group B with epidural bupivacaine (0.5%) and group D,with 0.5% bupivacaine and 1mcg per Kg of dexmedetomidine. We compared between the magnitude of variations in heart rate and mean arterial pressure, onset and duration of analgesia and surgical condition provided. Result: Variation in the heart rate of group B and group D (22.25±13.46bpm,18.64±9.91bpm: p 0.248) and MAP are (25.56±10.15 mm of Hg,26.46±10.48mm of Hg: p 0.737). The Chi Square value comparing surgical condition provided by the groups is 1.741. Onset of blockade of gp B and gp D are 10.56±2.61mins and 5.11±1.25,p value < 0.05. Duration of analgesia in gp B and gp D are 172.81±83.99mins and 367.14±251.08mins, p< 0.05. Conclusion; Addition of dexmedetomidine to bupivacaine in epidural anaesthesia has comparable hemodynamics with earlier onset and prolonged postoperative analgesia.

Keywords: Epidural dexmedetomidine, adjuvant, laparotomy.