A PROSPECTIVE STUDY OF EFFICACY AND CLINICAL PROFILE OF DEXMEDETOMIDINE AND FENTANYLAS AN ADJUVANT TO EPIDURAL ROPIVACAINE FOR POSTOPERATIVE PAIN RELIEF IN SPINE SURGERIES

Abstract

BACKGROUND: Spine surgeries are commonly associated with moderate to severe postoperative pain which remains a great challenge for the anaesthesiologist to treat it. Multimodal analgesic techniques like parenteral analgesics or regional analgesia are commonly practiced. Use of intrathecal opioids before surgical closure provide effective postoperative analgesia without any major side effects. This study was designed to compare the analgesic efficacy of Ropivacaine and Dexmedetomidine (RD) with Ropivacaine and Fentanyl (RF) by giving these drugs by epidural administration in patients undergoing elective spine surgeries.
MATERIALS AND METHODS: This study done at Department of Anaesthesiology ,ESIC Medical College, Kalaburagi patients were randomly selected based on inclusion criteria and after obtaining written informed consent, patients were allocated into two equal groups.(RD & RF) and the data were analysed.
RESULTS: The onset of sensory analgesia was earlier in Ropivacaine Dexmeditomidine (RD) group (5.93±0.700 min) than Ropivacaine Fentanyl (RF) group(7.67±0.702 min), peak effect of analgesia was 12.07min for RD group and 13.13min for RF group, mean duration of
analgesia was significantly longer in RD group than RF group(349.80± 8.124min vs 298.20±4.77min). Both groups showed haemodynamic stability. Visual Analogue Scale score between group RD and RF was1.79 and 2.31. Rescue analgesic requirement was less with RD group. Mean sedation score at various time intervals was significant between these groups. No episode of respiratory depression was noted in RD group.
CONCLUSION: Concluded from this study that epidural route provided adequate analgesia in both groups. However Dexmedetomidine seems to be a better alternative to Fentanyl as it provides early onset and establishment of sensory anesthesia prolonged postoperative analgesia lower consumption of postoperative rescue analgesia, comparablestable hemodynamics,
andmuch better sedation levels