Journal of Anesthesiology & Clinical Science

Journal of Anesthesiology & Clinical Science

ISSN 2049-9752
Original Research

Comparative study of dexmedetomidine and fentanyl as an adjuvant to epidural bupivacaine for postoperative pain relief in adult patients undergoing total knee replacement: a randomized study

Rabie Soliman1* and Moataz Eltaweel2

*Correspondence: Rabie Soliman rabiesoliman@hotmail.com

1. Department of Anesthesia, Cairo University, Egypt.

Author Affiliations

2. Department of Anesthesia, Menufyia University, Egypt.

Abstract

Background: Epidural analgesia is a common method for the management of postoperative pain after total knee replacement. The aim of the study was to compare the postoperative analgesic effect of dexmedetomidine and fentanyl as an adjuvant to epidural bupivacaine in adult patients undergoing total knee replacement.

Material and methods: The study included 460 cases classified randomly into two groups (each=230): Dexmedetomidine group: Dexmedetomidine 2 ml (100 μg) was mixed with 48 ml bupivacaine 0.125% in a syringe 50 ml and infused epidurally at a rate of 5ml/hr for the postoperative 72 hours. Group F (fentanyl group): Fentanyl 2 ml (100 μg) was mixed with 48 ml bupivacaine 0.125% in a syringe 50 ml and infused epidurally at a rate of 5ml/hr for the postoperative 72 hours.

Results: The quality of analgesia was better with dexmedetomidine than fentanyl group (p<0.05), and the requirement for opioids was significantly lower with dexmedetomidine than fentanyl group (p<0.05). The incidence of motor block, bradycardia, hypotension and dry mouth was significantly higher with dexmedetomidine than fentanyl group (p<0.05). The incidence of sedation was significantly higher with dexmedetomidine compared to fentanyl group (p<0.05), but after opioids administration, the incidence of sedation was significantly higher with fentanyl compared to dexmedetomidine group (p<0.05). The incidence of nausea and vomiting, pruritis, urinary retention, and respiratory depression was significantly lower with dexmedetomidine compared to fentanyl (p<0.05).

Conclusion: Dexmedetomidine is an ideal adjuvant to epidural bupivacaine for postoperative analgesia compared to fentanyl in patients undergoing total knee replacement.

Keywords: Dexmedetomidine, fentanyl, epidural bupivacaine, total knee replacement

ISSN 2049-9752
Volume 5
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