A comparative study of post-operative analgesic efficacy of 0.25 percentage ropivacaine with dexmedetomidine versus dexamethasone as an adjuvant in bilateral superficial cervical plexus block for midline neck surgery under general anaesthesia.

A comparative study of post-operative analgesic efficacy of 0.25 percentage ropivacaine with dexmedetomidine versus dexamethasone as an adjuvant in bilateral superficial cervical plexus block for midline neck surgery under general anaesthesia.

A study to compare post-operative effect of skin infiltration of   dexmedetomidine with ropivacaine versus dexamethasone with ropivacaine in midline neck surgery under general anaesthesia.

 OBJECTIVES

· To evaluate the duration of postoperative analgesia and requirement of analgesic doses during 24hours.

· To assess Ramsay sedation score.

· To assess intraoperative and postoperative haemodynamics.

· To find out duration of rescue analgesia.

· To detect Side effects/complication, if any.s

 Inclusion Criteria:

· Patients willing to participate in the studys.

· Patients of ASA Grade I and II of either gender.

· Patients undergoing elective midline neck surgeries under general anaesthesia

· Age of patients 18-65 years.

 Exclusion Criteria:

· Patient refusal.

· Patient not nil by mouth.

· Patients with uncontrolled systemic disease like heart disease, liver disease, kidney disease.

· Patients with anaemia, shock, septicaemia, uncontrolled hypertension.

· Patients with bleeding and coagulation disorders

· Infection at site Â· History of upper mediastinal irradication

· Inability to tolerate general anaesthesia

· Any neck metastasis

· History of previous head and neck surgery

· Hoarse and weak voice

 Methods:

This randomized clinical study will be conducted in Department of Anaesthesiology in Dhiraj hospital. After approval from institutional ethical committee a study will be conducted on 50 patients including both genders, aged between 18 to 65 years which will be equally divided randomly in 2 groups by chit method {Group A (0.25% Ropivacaine + Dexmedetomidine), Group B (0.25% ropivacaine + Dexamethasone)} for bilateral superficial cervical plexus block undergoing elective midline neck surgery under general anaesthesia will be selected. The drug will be administered by the anaesthesiologist not related to study. Group A (n=25) will receive 0.25% Ropivacaine 19ml + 50 mcg Dexmedetomidine 1 ml and Group B (n=25) will receive 0.25% Ropivacaine 19 ml + 4 mg Dexamethasone 1ml. All the patients will be explained clearly about the purpose and nature of the study in the language they can understand. They will be included in the study only after obtaining a written informed consent.

 Study site: DHIRAJ HOSPITAL, S.B.K.S. MEDICAL INSTITUTE AND RESEARCH CENTER, SUMANDEEP VIDYAPEETH DEEMED TO BE UNIVERSITY, PIPARIA, VADODARA, GUJARAT.

 Study design: randomized clinical study

 LIKELY OUTCOME / BENEFITS OF THE STUDY:

This study will help us to know which drug out of two will be provide post operative analgesia more effectively and reduces the post operative intravenous analgesic use within 24 hours after midline neck surgery.