Abstract
Background: Epidural anesthesia alloyed with opioids facilitates a dose sparing effect of local anesthetic and superior analgesia. The drugs such as dexmedetomidine and fentanyl are effective adjuvants to ropivacaine to provide efficient post-operative analgesia. Still, the findings are contradictory.

Aims and Objectives: The aims of the study were to assess the efficacy of 0.75% ropivacaine with 0.25 ml fentanyl and 0.5 ml dexmedetomidine in the patients undergoing lower abdominal surgeries.

Materials and Methods: A total of 80 cases undergoing lower abdominal surgeries above 21 years were recruited. Group RF administered with 18ml of 0.75% ropivacaine + 0.25 ml fentanyl. Group RD administered with 18ml of 0.75% ropivacaine + 0.5 ml dexmedetomidine. During intraoperative period, parameters such as sensory block, motor block by modified Bromage scale, pain score, and hemodynamic parameters were recorded. The sedation score was assessed using Ramsay sedation score.

Results: The mean difference of the events of sensory block and motor block between two study groups was statistically significant (P < 0.05). The mean systolic blood pressure (SBP) was comparatively less in Group RD than Group RF during the entire study period. The mean difference of SBP, heart rate, and mean arterial pressure was statistically significant (P < 0.05). Preoperatively, the diastolic blood pressure was higher in Group RD; later stages, the levels were lesser than Group RF. The mean sedation score was less in Group RD till 15 min, later, it was higher in Group RD than Group RF. Bradycardia was commonly associated post-operative complication in both the study groups followed by nausea and vomiting.

Conclusion: The fentanyl and dexmedetomidine are effective adjuvants to ropivacaine. However, dexmedetomidine has better efficacy in terms of prolonged duration of sensory block, motor block, and postoperative analgesia, minimal requirement of rescue analgesia and with less post-operative complications.

Key words: 0.75% Ropivacaine; 0.25 ml Fentanyl; 0.5 ml Dexmedetomidine; Lower Abdominal Surgery; Epidural Anesthesia