The Effect of Adding Epinephrine To Combination of 0.75% Ropivacaine and Dexmedetomidine in Epidural Anaesthesia for Lower Limb Surgeries- A Prospective, Double Blinded Randomized Control Study

The study is designed to evaluate efficacy of epidural anesthesia and postoperative analgesia by adding epinephrine to a combination of ropivacaine and dexmedetomidine in lower limb surgeries.

Epidural Dexmedetomidine as an adjuvant to Ropivacaine is associated with prolonged sensory and motor blockade, hemodynamic stability, prolonged postoperative analgesia and reduced demand for rescue analgesics when compared to plain Ropivacaine.

Whereas Epinephrine, a vasoconstrictor, decreases the absorption of local anesthetics into the bloodstream, which reduces its systemic toxicity when used as an adjuvant. Resulting, prolonged duration of anesthesia. It is also widely used for early differentiation of intravascular absorption.

In previous studies epinephrine improves the pain relief and reduces the side effects of a thoracic epidural infusion of ropivacaine and fentanyl after major thoracic or upper abdominal surgery.

We hypothesized that epidural isobaric 0.75% ropivacaine with dexmedetomidine and 1:1000 adrenaline would be comparable to isobaric 0.75% ropivacaine  with dexmedetomidine and normal saline, for the efficacy of anesthesia and analgesia, and in addition would provide a better postoperative recovery profile and readiness for discharge. The purpose of the present study is to observe the effect of mentioned study drugs in epidural anaesthesia for duration of sensory and motor block with duration analgesia.