Low-Dose Epidural Dexmedetomidine as an Adjuvant to Bupivacaine Versus Conventional Bupivacaine for Postoperative Analgesia: A Randomized Controlled Trial

TL;DR

Adding low-dose dexmedetomidine to bupivacaine improves postoperative pain control and hemodynamic stability compared to bupivacaine alone.

Contribution

Demonstrates that combining low-dose dexmedetomidine with bupivacaine enhances analgesia and reduces side effects.

Findings

Group BD had significantly lower VAS scores and fewer rescue analgesics compared to Group BB.

Group BD showed better hemodynamic stability with fewer adverse effects.

No significant difference in motor block between the two groups.

Abstract

Background

Epidural analgesia is widely employed in postoperative care for abdominal and lower limb surgeries, offering superior pain control, reduced opioid consumption, and improved postoperative recovery compared to systemic opioids.

Objective

The objective of this study is to evaluate postoperative analgesia following lower limb and abdominal procedures using low-dose epidural dexmedetomidine with 0.0625% bupivacaine against 0.125% bupivacaine.

Methods

Two groups of sixty American Society of Anesthesiologists (ASA) grades I and II adults undergoing elective surgery were randomly assigned: Group BB received bupivacaine 0.125%, while Group BD received epidural bupivacaine 0.0625% with dexmedetomidine (0.5 µg/kg). Over a day, assessments were made of the visual analog scale (VAS), hemodynamics, motor block (Bromage scale), Richmond Agitation-Sedation Scale (RASS), and rescue analgesia.

Results

Group BD required fewer rescue analgesics and had substantially lower VAS scores (p = 0.003). In the BD group without clinical hypotension, heart rate and mean arterial pressure (MAP) were somewhat lower. There was no discernible change in motor block. There were a few and controllable side effects.

Conclusion

The addition of dexmedetomidine to epidural bupivacaine has been shown to provide superior analgesia, enhanced hemodynamic stability, and a reduced incidence of adverse effects when compared to bupivacaine alone.

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