Dexmedetomedine-As an Adjuvant to Epidural Analgesia: Comparison Between Different Doses

Abstract

Background: Epidural analgesia offers superior pain relief and early mobilization, especially when a local anesthetic [LA] dose is combined with an adjuvant vs. an LA alone. Objective: The current study compares the analgesic and anesthetic efficiency of dexmedetomidine (1 and 2 μgkg-1) and levobupivacaine, as well as their respective side effects. Materials and methods: This study was conducted on a total of 60 ASA I-II patients aged between 20 and 70 years, who underwent elective lower limb operations. The patients that received 1 μgkg-1 dexmedetomidine plus levobupivacaine were assigned to Group 1 (n=30) and those that received 2 μgkg-1 dexmedetomidine plus levobupivacaine to Group 2 (n=30). Results: Group 2 showed a significantly shortened onset time of sensory block, time needed for maximum sensory level and prolonged duration of anesthesia. Postoperatively, the total dose of levobupivacaine used was significantly lower, patients experienced a higher level of sedation and postoperative analgesia. However, Bradycardia and hypotension were more pronounced in Group 2 patients. Conclusion: Dexmedetomedine 2 μgkg-1 as an adjuvant to epidural analgesia significantly prolonged the duration of anesthesia and provided excellent sedation and postoperative analgesia. Therefore, higher doses of epidural dexmedetomedine are recommended in long surgical operations to avoid delayed motor recovery, bradycardia and hypotension.