A Comparative Evaluation of Levobupivacaine Hydrochloride and Levobupivacaine Hydrochloride with Dexmedetomidine in Epidural Anesthesia and Postoperative Pain Relief undergoing Infraumbilical Surgeries.

ABSTRACT

Epidural anesthesia is a versatile technique which is widely used for surgeries for providing intra- and postoperative analgesia. Several adjuvants have been used to prolong the action of the local anesthetic agent used. Aims and objectives: We performed prospective randomized, double blinded controlled study on 90 patients to compare the effects of adding of dexmedetomidine to levobupivacaine in prolonging the analgesia produced by epidural levobupivacaine alone in patients undergoing infraumbilical surgeries and also compared the duration of motor block and sedation scores. Materials and methods: Ninety American Society of Anesthesiologists (ASA) I and II patients (18-60 years), under going infraumbilical surgery, were prospectively randomized to one of two groups to receive epidural anesthesia with 17 ml of 0.5% levobupivacaine + 3 ml of normal saline (group L) or epidural anesthesia with 17 ml of 0.5% levobupivacaine with 75 mg (0.75 ml) of dexmedetomidine +2.25 ml of normal saline (group LD). Various parameters hemodynamic changes, onset time of sensory and motor blockade, highest level of sensory blockade, duration of sensory and motor block, postoperative pain using visual analog scale (VAS) score, and any side-effects were recorded and data were statistical analyzed using student’s t-test by statistics calculator SPSS software. Results: The two study groups were similar for mean age, weight and duration of surgery. Mean duration of analgesia was significantly longer in group LD (438.33 ± 38.72 min) than in group L(271.2±23.77 min); p<0.05. Onset time of sensory and motor blockade was significantly less in group LD as compared to group L; p< 0.05. Duration of sensory and motor block was significantly higher in group LD when compared tog roup L(p < 0.05). More sedation was observed in group LD. Conclusion: Dexmedetomidine in a dose of 75 µg added as an adjuvant to 0.5% levobupivacaine for epidural anesthesia, during infraumbilical surgeries, prolongs the duration of analgesia of levobupivacaine and increases postoperative sedation, without any other adverse effects.