Indian Journal of Clinical Anaesthesia


Comparison of the Duration of Analgesia, Duration of Sensory and Motor Blockade and Incidence of Side Effects of Intrathecal 0.75% Isobaric Ropivacaine with Combination of 0.75% Isobaric Ropivacaine a


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Author Details: Vijayanand kannabiran, Pushpa rani anand

Volume : 3

Issue : 1

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 85

Article End Page : 95


Abstract

Introduction: Ropivacaine has a reduced risk of cardiotoxicity, neurotoxicity, and rapid recovery of motor function. Postoperative pain relief is an important issue with Ropivacaine. Dexmedetomidine which is a highly selective α-2 adrenergic agonist with eight times greater affinity for receptors than clonidine decrease the requirements of analgesics and   augment the effects of local anaesthetics.
Aim and Objective: Compare the analgesic efficacy of intrathecal isobaric 0.75% Ropivacaine with the combination of isobaric 0.75% Ropivacaine and Dexmedetomidine.
Study design: A prospective randomized double-blinded study.
Sample size: 100 patients were selected and allocated in two groups randomly.

Inclusion criteria

·         ASAI & II

·         Either sex

·         18-60 years for lower limb Orthopaedic surgery

Exclusion criteria:

·         Patient refusal

·         Patients who had contraindications for spinal anaesthesia

·         Allergy to local anaesthetics

·         Cardiac disease

·         Hypertension

Patients were divided into two following groups randomly by lot method.

·         Group R:    Received 3ml volume of 0.75% isobaric ropivacaine and 0.5ml normal saline.

·         Group D:    Received 3ml volume of 0.75% isobaric ropivacaine and 5µg dexmedetomidine in 0.5ml normal saline

Observations: Ropivacaine vs. plain 0.75% isobaric Ropivacaine given intrathecally in patients who underwent lower limb orthopedic surgeries.The following observations were made:

1.        The addition of 5ug Dexmedetomidine to 0.75% Ropivacaine significantly prolonged the duration of analgesia and the time to demand analgesia.

2.        The addition of dexmedetomidine intrathecally produced sedation that was arousable for  many hours compared to plain ropivacaine group

3.        The incidence of side effects such as hypotension and bradycardia were more in patients who received dexmedetomidine But shivering was greatly reduced in dexmedetomidine.

4.        No episode of respiratory depression was noted in both the study groups which are more common with opioids.

 

Keyword: Ropivacine, Dexmedetomidine, Intrathecal, Isobaric