Comparison of efficacy of epidural Levobupivacaine with Levobupivacaine plus Dexamethasone for lower limb surgery

Dr. Jyoti V. Kulkarni; Dr. Pankaj Patil

Volume : VIII, Issue : I, January - 2018

Comparison of efficacy of epidural Levobupivacaine with Levobupivacaine plus Dexamethasone for lower limb surgery

Dr. Jyoti V. Kulkarni, Dr. Pankaj Patil

Abstract :

Introduction

Levobupivacaine is a new long acting local anaesthetic an S(–) enantiomer of Bupivacaine. Dexamethasone, a corticosteroid has an anti–inflammatory property too so we want to study effect of Dexamethasone as an adjuvant to Levobupivacaine for epidural anaesthesia in lower limb surgery.

Aims and Objectives

To compare effect of epidural Dexamethasone plus 0.5% Levobupivacaine with 0.5% Levobupivacaine alone on onset and duration of sensory and motor blockade, intraoperative hemodynamic, post–operative analgesia and side effects in patients posted for lower limb surgeries.

Material and method

A prospective, randomized, controlled, double blinded study was conducted in 60 patients posted for lower limb surgery. After identification of epidural space Inj. 0.5% Levobupivacaine 20ml plus Dexamethasone 8mg (2ml) in Group D or Inj. 0.5% Levobupivacaine 20ml plus 2 ml normal saline in Group L.

Onset of Sensory blockade and motor blockade ,recovery from sensory and motor block, intra–operative haemodynamic and post–operative complications were documented and compared

Observation

Mean time required for onset of sensory block was 8.97 ± 1.03 min in Group D while it was 12.77 ± 1.7 min in Group L. Mean time required for onset for motor block was 15.13 ± 1.38 min in group D while it was 21.4 ± 1.75 min in group L. Time required for two segment regression in group D was 165.8 ± 5.05 minutes while in group L it was 125 ± 8.77 minutes. Time required for rescue analgesic was 237.7 ± 6.75 minutes in group D and it was 166.9± 8.37 minutes in group L. There was no statistically significant difference in quality of motor blockade, pulse rate and blood pressure between two groups. In group D, no complications were observed. In group L, 4(13.33%) patients had shivering which was transient, 2(6.67%) patients had nausea, vomiting.

Conclusion

We concluded that dexamethasone as an adjuvant in epidural anaesthesia leads to early onset of sensory and motor blockade with prolongation of postoperative analgesia without side effects.