Abstract

Background: This study was done to compare the effects of buprenorphine and dexmedetomidine as an adjuvant to ropivacaine in epidural route for lower abdominal surgeries especially hernia surgeries. Sixty patients between 18 to 60 years of both gender of ASA status I and II scheduled for elective hernia surgeries satisfying the inclusion and exclusion criteria were selected randomly allocated into 2 groups as Group A and Group B. The were investigated for RBS, RFT, LFT, CBC, Platelet count, CXR & 12 lead ECG. Group A received dexmedetomidine (0.5ml) (50mcg) with 0.5ml sterile normal saline 15 ml of 0.75% ropivacaine through epidural catheter. Group B received buprenorphine 0.5ml (150mcg) with 0.5ml sterile normal saline with 15 ml of 0.75% ropivacaine through epidural catheter. Before commencement of the procedure, patients were instructed on the method of sensory and motor assessments. After adequate sensory blockade (T10) patient was positioned for surgery. Intraoperatively assessment of sensory and motor blockade was done at the end of each minute after injecting 16 ml of the study drug. The onset time for the sensory and motor blockade and the duration of sensory and motor blockade were recorded. Vitals parameters were observed throughout the procedure till 24 hours. In our study, the time to onset of sensory blockade was faster in buprenorphine group (mean time=7.87 minutes) than in dexmedetomidine group (mean time=8.73 minutes). The time to onset of motor blockade was faster in buprenorphine group (mean time= 10.3 minutes) than in dexmedetomidine group (mean time=16.8 minutes). The duration of sensory blockade was more in buprenorphine group (mean time=466 minutes) than in dexmedetomidine group (mean time= 319.37 minutes). The duration of motor blockade was more in buprenorphine group (mean time= 433.5 minutes) than in dexmedetomidine group (mean time=258.9 minutes). The duration of analgesia was more in buprenorphine group (mean time=491.3 minutes) compared to dexmedetomidine (mean time=331.8 minutes). There is statistically significant difference in hemodynamic parameters where Heart rate, systolic blood pressure, diastolic blood pressure was lesser in dexmedetomidine group compared to Buprenorphine group. Only 6 patients in group A had hypotension compared to 2 patients in group B and it was effectively managed with Inj. Ephedrine 6 mg I.V.

Description