Abstract: Background: In contemporary orthopedic surgery, the ideal outcome is early postoperative mobilization and rehabilitation with only minor pain and discomfort. The present study compared ropivacaine with dexmedetomidine and ropivacaine with remifentanil for epidural anesthesia and analgesia in lower limb orthopedic surgery.

Materials & Methods: 90 patients scheduled for lower limb orthopedic surgery of both genders were divided into two groups of 45 each. Group I patients received Ropivacaine 0.75% 20 cc + 50mcg Inj. Remifentanyl (RF) and group II received Inj. Ropivacaine 0.75% 20 cc + Inj. Dexmedetomidine 50 mcg in normal saline diluted upto 1cc. Parameters such as time to onset of analgesia at T10, maximum sensory analgesic level, time to complete motor blockade, time to two segmental dermatomal regressions, and time to first rescue analgesic was recorded.

Results: Group I had 21 males and 24 females and group II had 25 males and 20 females. The mean duration of surgery (min) was 129.5 in group I and 105.6 in group II. Sensory block at T10 was 10.2 minutes in group I and in group II was 8.2 minutes. The mean time for maximum sensory block level (min) was 18.6 in group I and 15.2 minutes in group II. Complete motor block (min) was 23.1 in group I and 20.4 in group II. The mean dose of mephenteramine requirement was 9.6 mg in group I and 12.5 mg in group II. The difference was significant (P< 0.05). Complications were nausea/vomiting seen in 1 in group I, bradycardia seen in1 in group II, hypotension seen 1 in group I and 2 in group II and headache in 2 in group I and 1 in group II. The difference was significant (P< 0.05).

Conclusion: When combined with 0.75% ropivacaine in epidural anesthesia for lower limb orthopaedic surgery, dexmedetomidine functions as an excellent neuraxial adjuvant.