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Comparison of Epidural Bupivacaine, Levobupivacaine and Dexmedetomidine in Patients Undergoing Vascular Surgery

Authors :
Lakshmi Adalagere Sathyanarayana
Vijayakumar M. Heggeri
Parimala Prasanna Simha
Satish Narasimaiah
Manjunath Narasimaiah
Bharathi Katheraguppa Subbarao
Source :
Journal of Clinical and Diagnostic Research, Vol 10, Iss 1, Pp UC13-UC17 (2016)
Publication Year :
2016
Publisher :
JCDR Research and Publications Private Limited, 2016.

Abstract

Introduction: Levobupivacaine is the s-isomer of racemic Bupivacaine. It is less cardio, neurotoxic and equally potent local anaesthetic compared to its racemate. It is known to cause less Depression of myocardial contractility. Dexmeditomidine when used via epidural route has synergistic effect with local anaesthetics. Majority of patients presenting for vascular surgery are elderly and have associated co-morbidities like diabetes, hypertension, and coronary artery disease. We intend to study safety and efficacy of epidural Levoupivacaine and Dexmedetomidine in this group of patients. Materials and Methods: Sixty adult patients undergoing lower limb vascular surgery under lumbar epidural anaesthesia were randomly allocated to three groups. All groups were preloaded with 10ml/kg of crystalloid solution. B group was scheduled to receive 15 ml of racemic Bupivacaine, L-group was scheduled to receive 15ml of Levobupivacaine and LD-group received 15ml of Levobupivacaine with 0.5 mics/kg Dexmeditomedine. Time to onset of sensory block to T-10, maximum sensory level achieved, Bromage scale, time to two segment regression, time to total regression, sedation level achieved and patients assessment of quality of anaesthesia were assessed. Haemodynamic parameters were monitored throughout study period. Adverse effects were noted and treated appropriately. Results: Baseline parameters were comparable among all the groups. Time to onset of sensory block to T-10 and maximum level of block achieved, was comparable among the groups. Time to two segment regression and time to total regression was significantly prolonged in LD group compared to other two groups. There was significant bradycardia noted in LD group which required treatment. Conclusion: Levobupivacaine can be safely used in elderly high risk patients undergoing vascular surgery. Addition of dexmedetomidine prolongs the duration of anaesthesia and postoperative analgesia.

Details

Language :
English
ISSN :
2249782X and 0973709X
Volume :
10
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Journal of Clinical and Diagnostic Research
Publication Type :
Academic Journal
Accession number :
edsdoj.4af6e79ea1bf4cfb8e7c9254f2ff9982
Document Type :
article
Full Text :
https://doi.org/10.7860/JCDR/2016/17344.7079