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Anaesthetic and Analgesic Efficacy of Dexmedetomidine versus Fentanyl as an Adjuvant to Epidural Levobupivacaine for Total Abdominal Hysterectomy: A Prospective, Randomized, Controlled Study

BACKGROUND After Total abdominal hysterectomy (TAH) is a major surgery and is associated with significant morbidity, if pain is not adequately controlled intra- and post-operatively. Epidural analgesia with a variety of local anaesthetics and adjuvants is widely used for TAH as it provides both intra- and post-operative analgesia. Primary objective of our study is to compare the effect of epidural levobupivacaine with fentanyl versus levobupivacaine with dexmedetomidine for analgesia and motor blockade in patients undergoing Total Abdominal Hysterectomy. This is a prospective, double-blinded trial conducted among 100 women aged between 35 and 65 years of age who were allocated randomly into one of the two groups for elective total abdominal hysterectomies. Group D received epidural levobupivacaine 0.5% with dexmedetomidine as adjuvant, and the other group F received epidural levobupivacaine 0.5% with fentanyl as adjuvant. Complete motor block was achieved in significantly lower (p<0.001) time by Group D subjects as compared to Group F. Also, it was found that the duration of analgesia was significantly higher (p<0.001) in Group D (384.02 + 20.84 minutes) as compared to Group F (270.30 + 19.34 minutes). Dexmedetomidine is a better adjuvant to levobupivacaine than fentanyl for epidural analgesia with better quality of analgesia, prolonged duration of analgesia, higher sedation scores, and no significant side effects.