Comparing the Effectiveness and Safety of Intrathecal Dexmeditomidine and Fentanyl as an Adjuvant to Isobaric Ropivacaine.0.75 % In Lower Abdominal Surgeries: A Study Protocol

Abstract

Background: Spinal anaesthesia is a form of local anaesthesia, wherein conduction block of nerve roots is done with the aid of injecting a small dose of local anaesthesia into the subarachnoid space via a lumbar puncture in left lateral position in midline at L3 L4 interface. Drug is given after confirming free flow of CSF. Local anaesthetics work for a short duration and adjuvants are used for prolongation of postoperative analgesia. Ropivacaine, a brand new amide local anaesthetic, accepted via FDA IN 1997 and using it extensively in India since 2009. Ropivacaine due to its excessive Pka and decreased lipid solubility has received popularity. This study has been planned to compare the effects of injection Dexmedetomidine & injection Fentanyl as an Adjuvant to Intrathecal isobaric Ropivacaine 0.75% for lower abdominal surgeries. Materials and Methods: This will be a Comparative Experimental Prospective Study conducted at Anesthesiology department of AVBRH, Wardha. 80 patients will be randomized into two groups. One group will receive 3 ml of 0.75 percent isobaric ropivacaine with dexmedetomidine 10 mcg (Group RD). Another group will receive 20 mcg of fentanyl (Group RF) intrathecally for lower abdominal surgeries. Data on block characteristics, hemodynamic changes, and side effects will be collected and compared for the two groups. Expected Results: Clinically significant results are expected in terms of mean time needed and Mean of total sensory block length in Group RD compared to Group RF. Conclusion: Addition of 10μg dose of dexmedetomidine to 3ml of 0.75 percent isobaric ropivacaine produces earlier sensory blockade, prolonged sensory and motor blockade and improved sedation and post-operative analgesia.