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Comparative study of onset and total time required for sensory and motor blockade of epidural ropivacaine with clonidine and dexmedetomidine for lower limb surgeries

Shrirang N Bamne, Shrikrishna N Bamne, Shrikant N Bamne.

Abstract
Background: Use of ropivacaine in epidural anesthesia has increased in recent past. The high dose needed for satisfactory anesthesia in lower limb surgery can be associated with the adverse events. Dexmedetomidine and clonidine are used as adjuvants with ropivacaine, so that the dose of ropivacaine can be decreased and adverse events can be avoided.

Objective: To compare efficacy and safety of clonidine and dexmedetomidine as an adjuvant to ropivacaine for epidural anesthesia in lower limb surgery.

Materials and Methods: Subjects were divided randomly into two groups: Group RC, patient received ropivacaine 0.75% 20 mL with clonidine 2 mcg/kg (n = 30), and Group RD, patient received ropivacaine 0.75% 20 mL with dexmedetomidine 1.5 mcg/kg (n = 30). Sensory analgesia using pin prick method, Bromage scale for motor blockade, time to two dermatome regression of sensory level, visual analogue scale for analgesia, Ramsay sedation scale for sedation, and intraoperative hemodynamic parameters were evaluated.

Result: It was observed that onset of sensory blockade at T12 level was faster in group RD (6.00 2.03 min) as compared to group RC (7.33 2.54 min). Mean time duration of onset of motor blockade was shorter in group RD (7.17 2.52 min) as compared to group RC (12.67 2.86 min) and time to achieve highest sensory dermatome blockade was shorter in group RD (21.00 2.75 min) as compared to group RC (28.50 2.33 min). Also mean time duration for complete motor blockade was shorter in group RD (20.17 3.40 min) as compared to group RC (27.33 3.14 min).

Conclusion: Dexmedetomidine is better as an adjuvant as compared to clonidine.

Key words: Epidural block, ropivacaine, clonidine, dexmedetomidine, lower limb surgeries



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