Why the study?
Does epidural ropivacaine with dexmedetomidine or clonidine improve postoperative block characteristics and analgesia compared to ropivacaine alone in patients undergoing abdominal hysterectomy?
Does epidural ropivacaine with dexmedetomidine or clonidine improve postoperative block characteristics and analgesia compared to ropivacaine alone in patients undergoing abdominal hysterectomy?
Epidural dexmedetomidine is a superior adjuvant to ropivacaine compared to clonidine for prolonging analgesia and providing better sedation after abdominal hysterectomy.
May support dexmedetomidine as ropivacaine adjuvant for prolonged post-hysterectomy analgesia; leaves open need for larger confirmatory trials.
Regional anesthesia is widely used for abdominal hysterectomies. It is divided into spinal and epidural anaesthesia. Epidural anesthesia has got the advantage of extending the period of anesthesia to post-operative analgesia. We can use various pharmacological agents as adjuvants, which prolong the duration of action of local anesthetics. They include opiods, alpha 2 agonists like clonidine and dexmedetomidine. In this we studied the efficacy of local anesthetic agent -ropivacaine alone, ropivacaine with clonidine and ropivacaine with dexmedetomidine for epidural block. Present study showed that Epidural Dexmedetomidine and clonidine have synergistic action in combination with epidural ropivacaine resulting in smooth and prolonged postoperative analgesia and sedation. Group RD (Ropivacaine and Dexmedetomidine) had significant difference in comparison of postoperative block characteristics, such as time of two segment regression, time to Bromage scale 1, time of regression to S1 dermatome and time of first epidural top up than group RC and R. (Ropivacaine with clonidine and Ropivacaine alone). Thus epidural dexmedetomidine is a better neuraxial adjuvant in combination with epidural ropivacaine in producing prolonged analgesia and better sedation for abdominal hysterectomy.
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Satheedevi et al. (2015) studied this question.
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