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ORIGINAL ARTICLE
Year : 2018  |  Volume : 4  |  Issue : 2  |  Page : 53-56

Lumber plexus block for postoperative analgesia: effect of adding low dose dexmedetomidine to ropivacaine


1 Assistant Professor, Department of Anesthesia and Critical Care, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
2 Associate Professor, Department of Anesthesia and Critical Care, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
3 Consultant, Department of Anesthesia and Critical Care, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
4 Postgraduate Student, Department of Anesthesia and Critical Care, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India

Correspondence Address:
Mamta Mahobia
Department of Anesthesia and Critical Care, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.5005/jp-journals-10046-0104

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Introduction: Our aim is to assess the effect of adding 0.5μg/kg dexmedetomidine to 0.33% ropivacaine in lumbar plexus block (LPB) on postoperative analgesia and opioid consumption. This dose and concentration has not been used in LPB in previous studies. Materials and methods: This study enrolled 60 patients scheduled for hip surgery to receive either 32 mL of study drug which consisted of 30mL of ropivacaine 0.33% and 2 mL of Normal saline [Group RN (n = 30)] or 30 mL solution, in which dexmedetomidine 0.5 μg/kg was diluted in normal saline to reach a total volume of 2 mL and added to 30 mL of ropivacaine 0.33% Group RD (n = 30) before induction of general anesthesia. Postoperative analgesia was assessed with visual analog scale (VAS) scoring at 0,2,4,8,12,18,24 hours and patient satisfaction score(PSS) at 24 hour. Hemodynamic parameters were monitored perioperatively. Mann–Whitney U-test was applied for VAS and sedation scores. Unpaired t-test was applied for age, weight, duration of surgery and duration of post operative analgesia. Results: Sixty patients were analyzed. There was significant reduction in pain scores in Group RD compared to RN upto 8 hours postoperatively. Duration of analgesia was significantly increased in Group RD, 502 ±102 as compared to Group RN, 250 ± 116. Total analgesic requirement in form of opioid was also reduced by dexmedetomidine in first 24-hour. There was no difference in hemodynamic parameters and sedation scores throughout the study among both groups with nil complication. Conclusion: Low dose dexmedetomidine as an adjuvant to ropivacaine prolongs the time for first analgesic requirement and reduces the total postoperative opioid consumption without major side effects. Clinical significance: Limiting the dose of dexmedetomidine 0.5 μg/kg and ropivacaine concentration to 0.33% in combination, not only prolong duration of analgesia but also avoid undesirable side effects.


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