Comparative study of analgesic effects of ropivacaine and dexmedetomidine with that of ropivacaine and fentanyl for lower abdominal and lower limb orthopaedic surgeries
Keywords:
ropivacaine, dexmedetomidine, fentanyl, lower abdominal, lower limb orthopaedic surgeriesAbstract
Introduction: The anesthetic choices for lengthy lower limbs orthopedic procedures may comprise general anesthesia and limited types of regional techniques such as epidural, continuous spinal, or combined nerve blocks. Ropivacaine is a long-acting amide local anesthetic with a potentially improved safety profile when compared to bupivacaine. Dexmedetomidine and fentanyl are two such adjuvant drugs that have been used in combination with bupivacaine or ropivacaine to enhance the analgesic efficacy of the drugs and that facilitate early achievement and prolongation of block. Material and Methods: This is a Comparative, prospective and single study of postoperative epidural analgesia was done in 140 patients, posted for elective surgeries selected randomly, after approval from Ethical committee, conducted over a period of 6 months. Patients of either sex with age between 18 to 60 years. ASA grades I and II. Elective lower limb Orthopaedic and lower Abdominal surgery were included. Patients` refusal, Spinal deformities. Bleeding disorders, Neurological deficit. Local skin infection around the site of needle insertion and Allergic to local anaesthetic drugs were excluded. Results: A total of 140 patients of either sex selected in this study.
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Saravana Babu M, Verma AK, Agarwal A, Tyagi CM, Upadhyay M, Tripathi S. A comparative study in the postoperative spine surgeries: Epidural ropivacaine with dexmedetomidine and ropivacaine with clonidine for postoperative analgesia. Indian J Anaesth., 2013; 57(4): 371-6.
Taenzer AH, Clark C. Efficacy of postoperative epidural analgesia in adolescent scoliosis surgery: A metaanalysis. Paediatr Anaesth., 2010; 20: 135-43.
Bradshaw BG, Liu SS, Thirlby RC. Standardized perioperative care protocols and reduced length of stay after colon surgery. J Am Coll Surg., 1998; 186: 501 6.
Farmery AD, Wilson MacDonald J. The analgesic effect of epidural clonidine after spinal surgery: A randomized placebo-controlled trial. Anesth Analg., 2009; 108: 631-4.
Kehlet H, Mogensen T. Hospital stay of 2 days after open sigmoidectomy with a multimodal rehabilitation programme. Br J Surg., 1999; 86: 227 30.
Aryan HE, Box KW, Ibrahim D, Desiraju U, Ames CP. Safety and efficacy of exmedetomidine in neurosurgical patients. Brain Inj., 2006; 20: 791-8.
Zaric D, Nydahl PA, Philipson L, Samuelsson L, Heierson A, Axelsson K. The effect of continuous lumbar epidural infusion of ropivacaine (0.1%, 0.2%, and 0.3%) and 0.25% bupivacaine on sensory and motor block in volunteers: A double blind study. Reg Anesth., 1996; 21: 14 25.
Bajwa SJ, Bajwa SK, Kaur J, Singh G, Arora V, Gupta S, et al. Dexmedetomidine and clonidine in epidural anaesthesia: A comparative evaluation. Indian J Anaesth., 2011; 55: 116-21.
McClellan KJ, Faulds D. Ropivacaine: An update of its use in regional anesthesia. Drugs, 2000; 60: 1065 93.
Coskuner I, Tekin M, Kati I, Yagmur C, Elcicek K. Effects of dexmedetomidine on the duration of anaesthesia and wakefulness in bupivacaine epidural block. Eur J Anaesthesiol., 2007; 24: 535-40.
Arunkumar S, Hemanth Kumar VR, Krishnaveni N, Ravishankar M, Jaya V, Aruloli M. Comparison of dexmedetomidine and clonidine as an adjuvant to ropivacaine for epidural anesthesia in lower abdominal and lower limb surgeries. Saudi J Anaesth., 2015; 9(4): 404-8.
Benzon HT, Wong HY, Belavic AM Jr, Goodman I, Mitchell D, Lefheit T, et al. A randomized double blind comparison of epidural fentanyl infusion versus patientcontrolled analgesia with morphine for postthoracotomy pain. Anesth Analg., 1993; 76: 316 22.
Schultz AM, Werba A, Ulbing S. Perioperative thoracic epidural analgesia for thoracotomy. Eur J Anaesthesiol., 1997; 14: 600 3. 7. Kehlet H. Acute pain control and accelerated postoperative surgical recovery. Surg Clin North Am., 1999; 79: 431 43.
Salgado PF, Sabbag AT, Silva PC, Brienze SL, Dalto HP, Módolo NS, et al. Synergistic effect between dexmedetomidine and 0.75% ropivacaine in epidural anesthesia. Rev Assoc Med Bras., 2008; 54: 110-5.
Bajwa SJ, Arora V, Kaur J, Singh A, Parmar SS. Comparative evaluation of dexmedetomidine and fentanyl for epidural analgesia in lower limb orthopedic surgeries. Saudi J Anaesth., 2011; 5(4): 365-70.
Bharti N, Praveen R, Bala I. A dose-response study of caudal dexmedetomidine with ropivacaine in pediatric day care patients undergoing lower abdominal and perineal surgeries: a randomized controlled trial. Paediatr Anaesth 2014;24:1158-63.
Al-Zaben KR, Qudaisat IY, Abu-Halaweh SA, Al-Ghanem SM, AlMustafa MM, Alja’bari AN, et al. Comparison of caudal bupivacaine alone with bupivacaine plus two doses of dexmedetomidine for postoperative analgesia in pediatric patients undergoing infraumbilical surgery: a randomized controlled double-blinded study. Paediatr Anaesth 2015;25:883-90.
Dwijaya, A., & Atmaja, M. H. S. (2022). Clinical and imaging findings of klippel-trenaunay syndrome: A case report. International Journal of Health & Medical Sciences, 5(1), 145-149. https://doi.org/10.21744/ijhms.v5n1.1860
Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2021). Health and treatment of diabetes mellitus. International Journal of Health Sciences, 5(1), i-v. https://doi.org/10.53730/ijhs.v5n1.2864
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