Aim: So many adjuvants have been used with bupivacaine in epidural anaesthesia but none has been found ideal. We have conducted this study to evaluate the effect of epidural dexmedetomidine and ketamine when added to bupivacaine.

Methods: Fifty   female patients who underwent hysterectomies under epidural anesthesia were included in this study. They were randomly allocated in to two groups of 25 each. Group BK received epidural bupivacaine 0.5%(15ml)+0.5mg/kg of ketamine (1ml) and group BD received epidural bupivacaine 0.5% (15ml)+ 0.5 μg/kg of  dexmedetomidine (1ml). Following epidural administration, onset and duration of sensory and motor blockade, maximum dermatomal level achieved, duration of analgesia and incidence of side effects were recorded.

Results: Onset of sensory and motor block was earlier in group BD compared to group BK which was statistically significant. Block regression was significantly delayed with the addition of epidural dexmedetomidine (Group BD) as compared to group BK. The duration of analgesia was also significantly prolonged in group BD as compared to group BK. There were no significant difference either in haemodynamic parameters or in the incidence of side effects in both the groups.

Conclusion: Dexmedetomidine when added to epidural bupivacaine produces significantly longer sensory and motor blockade along with prolonged postoperative analgesia when compared to epidural ketamine. Dexmedetomidine provided   haemodynamic stability without any significant side effects.

Keywords:  Dexmedetomidine, bupivacaine, epidural, gynaecological, ketamine.

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Dr Aratiprava Sahu

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