Comparative Evaluation of 0.5% Levobupivacaine-Dexmedetomidine Versus 0.75% Ropivacaine-Dexmedetomidine for Epidural Anaesthesia in Lower Abdominal and Lower Limb Surgeries: A Prospective Study
Objective: Long-acting local anaesthetics combined with adjuvants are increasingly used in epidural anaesthesia to enhance block characteristics. This study compared the efficacy and safety of 0.5% levobupivacaine with dexmedetomidine versus 0.75% ropivacaine with dexmedetomidine for epidural anaesthesia in lower abdominal and lower limb surgeries. Methods: This prospective, comparative, hospital-based study included 100 ASA I and II patients aged 18–60 y, weighing 40–80 kg, scheduled for elective lower abdominal and lower limb surgeries over 18 mo. Patients were randomly allocated into two groups of 50 each. Group LD received 15 ml of 0.5% levobupivacaine with 50 mcg dexmedetomidine, while Group RD received 15 ml of 0.75% ropivacaine with 50 mcg dexmedetomidine epidurally at L1-L2 or L2-L3 interspace. Onset and duration of sensory and motor block, hemodynamic parameters, and adverse effects were recorded. Results: Group RD demonstrated significantly faster onset of sensory block (10.28±2.34 min vs 4.36±1.39 min, p<0.05) and motor block (14.42±2.56 min vs 9.08±2.25 min, p<0.05) compared to Group LD. However, Group LD provided significantly longer duration of sensory block (354.6±59.86 min vs 195±22.07 min, p=0.001) and motor block (231.7±13.42 min vs 147±13.27 min, p=0.001). Both groups maintained hemodynamic stability with no significant differences in heart rate, blood pressure, or mean arterial pressure throughout the study period (p>0.05). Conclusion: While ropivacaine-dexmedetomidine combination offers faster onset, levobupivacaine-dexmedetomidine provides superior duration of anaesthesia and postoperative analgesia with comparable hemodynamic stability. Both combinations are safe and effective for epidural anaesthesia in lower abdominal and lower limb surgeries.