IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-7-3-14421 Original Research Paper COMPARISON OF EPIDURAL DEXMEDETOMIDINE AND TRAMADOL AS ADJUVANTS TO BUPIVACAINE IN THE LOWER LIMB SURGERY : A RANDOMIZED CLINICAL STUDY Shashank Maladkar Dr. Dr Shivananda PT Dr. March 2018 7 3 01 02 ABSTRACT

 

Background and Aims: Various opioids, α–2agonists, magnesium sulphate, neostigmine are used as adjuvants with local anesthestic in epidural space. The present study aims at comparing the efficacy of epidurally administered dexmedetomidine& tramadol when combined with bupivacaine. Methods: A total of 60 patients of both gender aged 18–60 years, ASA physical status I and II who underwent lower limb orthopaedic surgery were enrolled into the present study. Patients were randomly divided into two groups: Bupivacaine + Dexmedetomidine(BD) and Bupivacaine + Tramadol (BT), comprising 30 patients each. Inj. Bupivacaine12 ml of 0.5% was administered epidurally in both the groups with addition of1 μg/kg of dexmedetomidine in BD group and 1 mg/kg of tramadol in BT group diluted to 3cc with total volume of study drug of 15ml. Besides cardio–respiratory parameters and sedation scores, various block characteristics were also observed which included time to onset of analgesia at T10, maximum sensory analgesic level, time to complete motor blockade, time to two segmental dermatomal regressions, and time to first rescue analgesic. At the end of study, data was compiled & analysed using ANOVA with post–hoc significance, Chi–square test and Fisher’s exact test. Value of P<0.05 is considered significant. Results: Demographic data was comparable in both groups. Onset of sensory analgesia at T10 (7.22±1.86 vs 10.02±2.26) and establishment of complete motor blockade (19.02±3.34 vs 23.45±5.65) was significantly earlier in the BD group. Postoperative analgesia was prolonged significantly in the BD group (355.88±14.52). Sedation scores were much better in the BD group and highly significant on statistical comparison (P<0.001).Conclusions: Dexmedetomidine seems to be a better alternative to tramadol as an epidural adjuvant as it provides early onset, and establishment of sensory anaesthesia, prolonged post–operative analgesia and much better sedation levels.