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BACKGROUND Uncontrolled postoperative pain may produce a range of detrimental acute and chronic effects. Spinal anaesthesia provided by Bupivacaine may be too short for providing postoperative analgesia. This study is conducted to evaluate the efficiency of intrathecal Fentanyl and intrathecal Dexmedetomidine as an adjuvant to hyperbaric Bupivacaine with regards to onset and duration of sensory and motor blockade as well as postoperative analgesia and adverse effects. The aim of this study is to study the duration of sensory and motor block of dexmedetomidine and fentanyl. MATERIALS AND METHODS Hundred patients aged 18 - 55 years were randomly divided into two groups by a computer program; each group consisting of 50 patients of either sex belonging to ASA Class 1 and 2, posted for elective lower abdominal surgeries were given spinal anaesthesia using Bupivacaine 0.5% heavy 2.5 mL with either Fentanyl 25 ug Group F or preservative-free Dexmedetomidine 5 ug Group D. Assessment of sensory and motor blockade were done at the end of each minute till the maximum level achieved. Measurement of blood pressure, pulse rate, respiratory rate and arterial oxygen saturation were obtained. Postoperatively, patients were observed for the duration of analgesia, time taken for complete regression of sensory blockade and time taken for complete recovery of motor power. RESULTS Our results showed a statistically highly significant prolongation of sensory and motor blockade, time taken for sensory regression by two segments and postoperative analgesia in Dexmedetomidine group compared to Fentanyl group. Incidence of pruritus is significantly high in fentanyl group. CONCLUSION Dexmedetomidine in the dose of 5 ug significantly prolongs the duration of sensory and motor blockade, time taken for sensory regression by two segments and duration of postoperative analgesia than Fentanyl 25 ug when added to Bupivacaine 0.5% heavy.

BACKGROUND Different local anaesthetics are used for epidural anaesthesia, most popular in India being lidocaine and bupivacaine. Bupivacaine is a longacting amide local anaesthetic, which is widely used for many years. However, it is associated with a number of side effects like Central Nervous System (CNS) toxicity and cardiotoxicity. Ropivacaine has been introduced recently in India and has been developed as a possible alternative to bupivacaine. It has a lower lipophilicity than bupivacaine and hence associated with a decreased potential for CNS and cardiotoxicity. The aim of the study is to compare the time of onset of sensory and motor block, duration of sensory and motor blockade and also the haemodynamic changes produced by bupivacaine 0.5% and ropivacaine 0.75% for epidural in elective lower limb and lower abdominal surgeries. MATERIALS AND METHODS 60 patients aged 18-55 yrs. scheduled for elective lower limb and lower abdominal surgeries belonging to ASA class I and II were given epidural anaesthesia using 15 mL of 0.5% bupivacaine (group B) and 15 mL of 0.75% ropivacaine (group R). Assessment of the sensory and motor blockade was done at intervals till maximum level achieved. Measurements of blood pressure, heart rate and arterial oxygen saturation were obtained at various time intervals. The total duration of the sensory blockade and motor blockade were also noted. RESULTS Our results showed no significant difference between the groups regarding sensory and motor onset time and time to attain and maximum level of sensory block. Our results also showed a significant difference in the intensity of motor blockade and the time to attain the maximum motor blockade, the total duration of analgesia and duration of motor blockade. CONCLUSION Hence, it is concluded that epidural ropivacaine 0.75% produces a more intense as well as prolonged motor blockade and prolonged sensory blockade than 0.5% bupivacaine. Epidural ropivacaine 0.75% can be a safe and effect alternative to bupivacaine 0.5% in lower limb and lower abdominal surgeries.

AIM Ever since the times spinal anaesthesia has been introduced by August Bier, multiple drugs at different dosages, concentrations and differing baricities have been studied. This study was conducted to compare the anaesthetic efficacy of intrathecal isobaric 0.5% ropivacaine, isobaric 0.5% bupivacaine and isobaric levobupivacaine in lower abdominal and lower limb surgeries, in 150 ASA grade I and II patients of both sexes in the age group of 19-65 years undergoing elective surgery under spinal anaesthesia. MATERIALS & METHODS After getting ethical committee approval and informed written consent from the patients, 150 patients were allocated into three groups of 50 patients each. The baseline pulse rate and mean arterial pressure were recorded. The first group A received 3ml of isobaric 0.5% ropivacaine (5mg/ml), the second group received 3ml of isobaric 0.5% bupivacaine and the third group C received 3ml of isobaric levobupivacaine intrathecally. The onset of sensory and motor blocks, duration of sensory and motor blocks was recorded in three groups. RESULTS The results were analyzed statistically using epidemiologically information package. On comparison of data we have found that the intrathecal isobaric 0.5% ropivacaine produces delayed onset of both sensory and motor block but of shorter duration which is statistically significant when compared with that of isobaric 0.5% bupivacaine and levobupivacaine. There is no significant inter-group difference between bupivacaine and levobupivacaine except for the mean duration of sensory block, which is more in levobupivacaine group. The quality of motor block which was assessed by Bromage scale, shows relatively lesser degree of motor block for ropivacaine group, when compared with that of bupivacaine and levobupivacaine groups. The haemodynamics were also recorded. The incidence of hypotension and Bradycardia is more in bupivacaine group. The height of block (peak sensory level) is higher for bupivacaine group followed by levobupivacaine and then ropivacaine. T4+T6% of Groups A, B& C are 5%, 48% and 44% respectively.