Background:Epidural anaesthesia is widely used for lower limb orthopaedic surgeries because of its ability to provide effective intraoperative anaesthesia and prolonged postoperative analgesia. Addition of adjuvants such as dexmedetomidine, clonidine, and fentanyl toepidural local anaesthetics improves block characteristics and haemodynamic stability. This study was conducted to compare the effects of dexmedetomidine, clonidine, and fentanyl on intraoperative haemodynamics when used as adjuvants to epidural ropivacaine.Methodology:This randomized prospective comparative study was conducted in the Department of Anaesthesiology, Sree Mookambika Institute of Medical Sciences, Kulasekharam, from February 2025 to November 2025. A total of 45 ASA grade I and II patients aged 20–60 years undergoing lower limb orthopaedic surgeries under epidural anaesthesia were randomly divided into three groups of 15 each. Group A received ropivacaine with dexmedetomidine, Group B received ropivacaine with clonidine, and Group C received ropivacaine with fentanyl. Intraoperative haemodynamic parameters, onset and duration of sensory and motor blockade, analgesia, and adverse effects were assessed.Results:A statistically significant fall in systolic, diastolic, and mean arterial pressure was observed in Groups B and C from 15 to 120 minutes after epidural block (p<0.05). Dexmedetomidine demonstrated better haemodynamic stability compared to clonidine and fentanyl groups. All three groups provided effective anaesthesia and satisfactory analgesia with manageable adverse effects.Conclusion:Dexmedetomidine, clonidine, and fentanyl are effective epidural adjuvants in lower limb orthopaedic surgeries. Dexmedetomidine showed superior haemodynamic stability and prolonged analgesic effect with minimal adverse effects.
Dr. Sreekala, Dr. Subhasan JV· Asian Journal of Medical Res...· 0 citations
Background:Functional Endoscopic Sinus Surgery (FESS) requires a clear and bloodless surgical field for optimal visualization and prevention of intraoperative complications. Controlled hypotension is commonly employed during FESS to reduce blood loss and improve surgical conditions. Dexmedetomidine and Propofol are widely used agents for controlled hypotensive anesthesia. The present study was conducted to compare the efficacy of dexmedetomidine and propofol infusion in achieving controlled hypotension during FESS.Methodology:This prospective randomized comparative study was conducted in the Department of Anaesthesiology at Sree Mookambika Institute of Medical Sciences from June 2025 to March 2026. A total of 100 patients aged between 18 and 40 years belonging to ASA Grade I and II undergoing elective FESS were included in the study. Patients were randomly allocated into two groups of 50 each. Group D received dexmedetomidine infusion at 0.4–0.8 μg/kg/hr, while Group P received propofol infusion at 75–100 μg/kg/min following induction of general anesthesia. Intraoperative pulse rate, mean arterial pressure, blood loss, quality of surgical field, sedation score, and complications were assessed and compared between the two groupsResults:Baseline demographic and hemodynamic parameters were comparable between the groups. Intraoperative pulse rate and mean arterial pressure were significantly lower in the dexmedetomidine group at various time intervals compared with the propofol group (p<0.05). Quality of surgical field and mean blood loss were comparable in both groups. Postoperative Ramsay sedation scores at 30 minutes were significantly higher in the propofol group (p=0.023). No major complications were observed in either group.Conclusion:Both dexmedetomidine and propofol were effective and safe agents for controlled hypotension during FESS. Dexmedetomidine provided superior intraoperative hemodynamic stability with comparable surgical field quality and blood loss, making it a useful alternative to propofol for hypotensive anesthesia in endoscopic sinus surgery.
Dr. Balakrishnan, Dr. Subhasan JV· Asian Journal of Medical Res...· 0 citations
