부산대학교 도서관

Background: Postoperative pain is the major cause of fear and anxiety leading to prolonged hospital admission and delayed discharge rates in hospitalized patients. So, to make the patient pain free, multimodal analgesia has been used since long time. Opioids as an adjunct to epidural local anaesthetics by many people, but opioid free analgesia is a major concern in recent times to avoid its respiratory depressant and other adverse effects. Objective: studying non opioid drugs namely a2 agonist dexmedetomidine and magnesium sulphate as an adjunct to epidural bupivacaine and to compare their hemodynamic, sedative and analgesic effects. Methods: A randomized double blinded study was conducted in 60 patients of either sex belonging to ASA class I and II scheduled for elective lower abdominal and lower limb surgeries under epidural anaesthesia. They were divided randomly into two groups (n = 30). After epidural block, test dose was given with 3 ml 2% lignocaine with adrenaline. Both the groups received 15ml 0.5% bupivacaine, group MB received 50mg magnesium sulphate and group DB received 25μg dexmedetomidine. Onset and duration of sensory blockade, motor blockade; time required for first rescue analgesia; Ramsey sedation score; cardiorespiratory parameters and adverse events were recorded. Result: Onset of sensory and motor blockade was rapid: duration of sensory and motor blockade; and the time for rescue analgesic was prolonged with higher sedation in group DB. Cardiorespiratory parameters and adverse effects were comparable between the two groups. Conclusion: Addition of dexmedetomidine to epidural bupivacaine can be advantageous with increased duration of sensory and motor blockade with arousable sedation, acceptable side effects and better patient comfort compared to addition of magnesium sulphate. [ABSTRACT FROM AUTHOR]