Abstract

EVALUATION OF ADDITION OF DEXAMETHASONE (8MG) TO BUPIVACAINE 0.5% FOR EPIDURAL ANAESTHESIA IN PATIENTS UNDERGOING LOWER LIMB ORTHOPEDIC SURGERY

Aditi Dhimar, Pinalben Dabhi, Ashish Soneji, M.P.Golwala, M.R.Upadhyay

ABSTRACT

Aims and objectives: The aim of the study was to do evaluate the effect of addition of dexamethasone(8 mg) to bupivacaine 0.5% for epidural anaesthesia & to observe the effect on blockade characteristics, hemodynamic parameters, duration of postoperative analgesia and number of rescue analgesic required in 24 hours & to note intra-operative/post-operative complication if any. Materials & methods: A prospective randomized study of 60 patients of either sex, 18-65 years and of ASA I-II category was performed. All patients were divided into group BD(n=30) and group B(n=30)& premedicated with Inj. Atropine 0.6mg iv and Inj. Ranitidine 50 mg iv and Epidural anaesthesia established with either Group BD: Inj. Bupivacaine 0.5% 18ml + Inj. dexamethasone (8mg) 2 ml 0r Group B: Inj. Bupivacaine 0.5% 18 ml+ Inj. Normal saline 2ml(total volume 20 ml). Results: Duration of sensory block prolonged in Group BD 325±50.5 min as compared to in Group B 224.0 ±17.14 min. Motor blockade followed the same pattern as sensory blockade .The mean duration of analgesia was 654±104.34 min in Group BD as compared to 430.67±51.46 min in Group B. Also the analgesic requirement in 24hr post-operative period was less 2.16±0.38 in Group BD as compared to 2.83±0.53 in Group B (p<0.001) with stable hemodynamic parameters intra & postoperatively. Conclusion: Addition of dexamethasone to bupivacaine 0.5% in epidural anaesthesia quickens the onset, early peak effect and prolongs the duration of sensory & motor block, prolonged duration of analgesia without affecting the other parameters and complications of epidural block.

Keywords: Epidural anaesthesia, Dexamethasone, Bupivacaine.