PROSPECTIVE RANDOMISED COMPARITIVE STUDY ON EFFECTS OF ADDING DEXMEDETOMIDINE AND FENTANYL TO EPIDURAL BUPIVACAINE ON POST OPERATIVE ANALGESIA IN PATIENTS UNDERGOING LOBECTOMY.

Aim: To compare the duration and quality of postoperative analgesia between fentanyl and dexmedetomidine when added epidurally to bupivacaine in patient undergoing lobectomy. Materials and methods: After obtaining institutional ethical approval adult patients aged 18 to 60 years undergoing elective lobectomy with ASA PS II &III who have given valid informed consent patients were divided into two groups. Group D and group F. Group allocation was done by closed envelope method. Group D - received 8 ml of 0.125% bupivacaine and 1 mic/kg of dexmedetomidine diluted to 2 ml via the epidural catheter. Group F-received 8 ml of bupivacaine and 1 mic/kg of fentanyl diluted to 2 ml via epidural catheter. Result: This double-blinded prospective randomised controlled study was done to evaluate the duration of analgesia as well as sedation and adverse effects of dexmedetomidine (1 mic/kg) and fentanyl (1 mic/kg) given via epidural route with 0.125% bupivacaine in patients postoperatively who underwent lobectomy surgeries under general anaesthesia. This study analysed the duration of postoperative analgesia, quality of analgesia, the side effects and the hemodynamic changes which showed that dexmedetomidine was better than fentanyl in many aspects. Conclusion: In conclusion dexmedetomidine appears to have a beneficial effect as an adjuvant to local anaesthetic by improving the quality and increasing the duration of analgesia without the side effects associated with opioids like respiratory depression. It has minimal side effects and good hemodynamic stability, however its routine use in epidural route requires caution with regard to its effects due to central sympatholytic property and further studies are necessary to quantify the required dosage.