Abstract

Pain after thoracotomy is one of the most severe pains after surgery. Respiratory muscle splinting due to poor control of post-operative pain may lead to respiratory complications and delayed recovery. In studies addition of dexmedetomidine or fentanyl to local anaesthetics showed enhanced quality of anaesthesia, reduced post-operative analgesic requirement and improved quality and duration of sensory neural blockade. But there are very few studies comparing dexmedetomidine and fentanyl as an adjuvant to ropivacaine in paravertebral block for post thoracotomy analgesia. 80 patients scheduled to undergo elective thoracotomy were randomly divided into two groups. Group A patients received infusion of 0.2% ropivacaine + 2µg/ml(microgram/millilitre) fentanyl @ 0.1ml/kg/h(millilitre/kilogram/hour) and Group B patients received infusion of 0.2% ropivacaine + 1µg/ml dexmedetomidine @ 0.1ml/kg/h in continuous paravertebral block. The patients had visual analogue scale(VAS) at rest between 1-3 in fentanyl group and 1-2 in dexmedetomidine group.(p value >0.05) The mean VAS score for the severity of pain at coughing was between 2-3 in fentanyl group and 1-2.5 in dexmedetomidine group and the difference is statistically significant.(p value <0.05) 12 patients in fentanyl group received rescue analgesic compared to 4 patients in dexmedetomidine group.(p value <0.05) Total fentanyl consumption was more in fentanyl group compared to dexmedetomidine group.(p value >0.05) There was no difference in incidence of side effects in both groups.(p value >0.05) Dexmedetomidine as an adjuvant to ropivacaine provided better post-operative analgesia during coughing and significantly reduced the requirement of rescue analgesic in comparison to fentanyl group without any significant adverse effects.

Description