A Cross-Sectional Study Of Epidural Bupivacaine With Dexmedetomidine And Epidural Bupivacaine With Clonidine In Patients Undergoing Lower Limb Orthopaedic Surgeries
DOI:
https://doi.org/10.64252/hea7ha20Keywords:
Epidural anesthesia, Dexmedetomidine, Clonidine, Bupivacaine, Sensory block, Motor block, Postoperative analgesia, Orthopaedic surgeries.Abstract
Background:
Epidural anesthesia is a preferred technique for lower limb orthopaedic surgeries due to its effectiveness in providing intraoperative anesthesia and postoperative analgesia. The addition of α2-adrenergic agonists like dexmedetomidine and clonidine as adjuvants to bupivacaine has shown promise in enhancing block characteristics and prolonging analgesia. However, comparative data on their efficacy remain limited.
Aim:
To observe and compare the clinical efficacy of epidural bupivacaine with dexmedetomidine versus bupivacaine with clonidine in patients undergoing lower limb orthopaedic surgeries.
Methods:
A hospital-based cross-sectional study was conducted among 40 patients undergoing elective lower limb orthopaedic surgeries. Participants were randomized into two groups of 20 each: Group A received epidural bupivacaine with dexmedetomidine, and Group B received epidural bupivacaine with clonidine. Onset and duration of sensory and motor block, hemodynamic parameters, and time to first rescue analgesia were assessed. Data were analyzed for statistical significance using appropriate tests.
Results:
Group A (dexmedetomidine) demonstrated a significantly faster onset of sensory block at T10 and earlier attainment of T6 level block compared to Group B (clonidine). The time to achieve maximum motor block was also shorter in Group A. Postoperatively, Group A exhibited prolonged sensory regression (two-segment and S1), delayed motor recovery, and extended time to first rescue analgesia. All differences between the groups were statistically significant (p < 0.05), with stable hemodynamic profiles observed in both groups.
Conclusion:
Epidural dexmedetomidine is more effective than clonidine as an adjuvant to bupivacaine in lower limb orthopaedic surgeries. It provides faster onset, longer duration of sensory and motor blockade, and superior postoperative analgesia without compromising patient safety.