Low-Dose Epidural Dexmedetomidine as an Adjuvant to Bupivacaine Versus Conventional Bupivacaine for Postoperative Analgesia: A Randomized Controlled Trial.

Background Epidural analgesia is widely employed in postoperative care for abdominal and lower limb surgeries, offering superior pain control, reduced opioid consumption, and improved postoperative recovery compared to systemic opioids. Objective The objective of this study is to evaluate postoperative analgesia following lower limb and abdominal procedures using low-dose epidural dexmedetomidine with 0.0625% bupivacaine against 0.125% bupivacaine. Methods Two groups of sixty American Society of Anesthesiologists (ASA) grades I and II adults undergoing elective surgery were randomly assigned: Group BB received bupivacaine 0.125%, while Group BD received epidural bupivacaine 0.0625% with dexmedetomidine (0.5 µg/kg). Over a day, assessments were made of the visual analog scale (VAS), hemodynamics, motor block (Bromage scale), Richmond Agitation-Sedation Scale (RASS), and rescue analgesia. Results Group BD required fewer rescue analgesics and had substantially lower VAS scores (p = 0.003). In the BD group without clinical hypotension, heart rate and mean arterial pressure (MAP) were somewhat lower. There was no discernible change in motor block. There were a few and controllable side effects. Conclusion The addition of dexmedetomidine to epidural bupivacaine has been shown to provide superior analgesia, enhanced hemodynamic stability, and a reduced incidence of adverse effects when compared to bupivacaine alone.