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Comparative study of hemodynamic profile in intraoperative period and side effects of epidural ropivacaine with clonidine and dexmedetomidine for lower limb surgeries

Shrikrishna Bamne, Shrirang Bamne, Avantika Bamne.

Abstract
Background: Epidural anesthesia gained great popularity by virtue of its distinct advantages over spinal anesthesia, such as provision of extended anesthesia in prolonged surgeries; early ambulation of patients, which reduces the hospital stay; and reduced incidence of postsurgical complications such as deep vein thrombosis.

Objective: To study ropivacaine with clonidine and dexmedetomidine in epidural anesthesia for lower limb surgeries with respect to hemodynamic profile in intraoperative period and their side effects.

Materials and Methods: Sixty patients of either sex of ASA grades I and II aged between 20 and 60 years were included in the study and randomly divided in two groups: group RC, patient received ropivacaine (0.75% 20 mL) with clonidine (2 mcg/kg; n = 30); group RD, patient received ropivacaine (0.75% 20 mL) with dexmedetomidine (1.5 mcg/kg; n = 30). The hemodynamic parameters recorded were mean heart rate, mean systolic blood pressure, mean diastolic blood pressure (DBP), and mean arterial pressure (MAP), respiratory rate, and oxygen saturation. These parameters were recorded preoperatively and then at 5-min intervals during intraoperative period till the end of the surgery. The study was carried out in the Department of Anesthesia, Grant Medical College Hospital, Indore, Madhya Pradesh, and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India.

Results: Heart rate was lower in group RD compared with group RC from 10 to 40 min intraoperatively, although it remained stable throughout the intraoperative period in both the groups. DBP was lower in group RD compared with group RC from 15 to 20 min intraoperatively. MAP was lower in group RD compared with group RC from 10 to 20 min intraoperatively, although it remained stable throughout the intraoperative period in both the groups. Oxygen saturation and respiratory rate showed no statistically significant differences and remained stable throughout the intraoperative period in both the groups. The incidence of side effects such as nausea, vomiting, dizziness, headache, and respiratory depression was nil in both the groups, while the incidence of dry mouth in both the groups was equal 36.33%, and the difference was not significant.

Conclusion: Hemodynamic parameters such as heart rate, blood pressure, oxygen saturation, and respiratory rate remained stable throughout the intraoperative period with both dexmedetomidine and clonidine.

Key words: Ropivacaine, clonidine, dexmedetomidine, hemodynamic parameters, side effects



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