A COMPARISON OF DEXMEDETOMIDINE AND FENTANYL AS AN ADJUVANT TO 0.25% BUPIVACAINE FOR EPIDURAL ANALGESIA IN PERCUTANEOUS NEPHROLITHOTOMY (PCNL)

Abstract

Background: PCNL can be performed under general anesthesia or regional anesthesia. PCNL is usually performed under general anesthesia due to better control of breathing and more comfort for the patients.

Methods: The study was conducted on 75 patients devided in 3 groups (n=25 in each group) undergoing PCNL. After obtaining permission from Research review board and institutional ethics committee. Informed and written consent was obtained from all patients for performance of epidural anaesthesia after complete explanation about the study protocol, side effects related to the drugs and procedure to the patient.

Results: The onset of sensory block was comparable in group B(7.28 ± 0.93min) and group C (6.88 ± 0.97min) , faster when compared to group A (8.16 ± 0.85min) group. The mean time of onset of motor block was comparable in group C (18.08 ± 1.41min) and group B (20.56 ± 1.61min) but slightly faster when compared to group A (26.08 ± 1.19min) group. The mean VAS score was lower in GroupC followed by GroupB and was highest in GroupA from 2hours to 5hours after surgery. Sedation score was significant higher in Group C (p<0.001) as compared to Group A and B and there was no significant difference between Group A and B.

Conclusion: We conclude that PCNL can be performed using 0.25% bupivacaine in epidural anaesthesia without compromising on patient's comfort and surgeon's satisfaction.

Keywords: Percutaneous nephrolithotomy (PCNL), Dexmedetomidine, Fentanyl, Bupivacaine