title: Epidural ropivacaine with dexmedetomidine reduces propofol requirement based on bispectral index in patients undergoing lower extremity and abdominal surgeries.
abstract: OBJECTIVE
  To assess the amount of propofol required for induction based on bispectral index (BIS) after administering epidural anesthesia with ropivacaine alone and ropivacaine with dexmedetomidine in patients undergoing lower extremities and abdominal surgeries.
  
  
  METHODS
  A double-blinded randomized clinical trial was carried out in 60 patients over a period of 2 years in a tertiary care hospital. American Society of Anaesthesiologists I or II in age group 18-65 years were included in the study. Group R received epidural anesthesia with ropivacaine alone, and Group D received ropivacaine and dexmedetomidine. General anesthesia was induced with propofol under BIS monitoring after 15 min. Onset of sensory and motor block, time for loss of consciousness and total amount of propofol used during induction to achieve the BIS value < 55 were recorded. Student's t-test and Chi-square test were used to find the significance of study parameters.
  
  
  RESULTS
  Time of onset of sensory block (Group R 11.30 ± 1.64/Group D 8.27 ± 0.83 min), motor block (Group R 14.16 ± 1.33/Group D 12.63 ± 1.22 min), time for loss of consciousness (Group R 90.57 ± 11.05/Group D 73.67 ± 16.34 s), and total amount of propofol (Group R 129.83 ± 22.38/Group D 92.13 ± 12.93 s) were reduced in Group D which was statistically significant with P < 0.001.
  
  
  CONCLUSIONS
  Epidural ropivacaine with dexmedetomidine significantly reduces the total propofol dose required for induction of anesthesia. Also, it decreases the onset time of sensory and motor block and provides good hemodynamic stability.
authors.affiliation: Department of Anaesthesia, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Renu
authors.initials: R
authors.lastname: Joy
authors.affiliation: Department of Anaesthesia, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Vinayak Seenappa
authors.initials: VS
authors.lastname: Pujari
authors.affiliation: Department of Anaesthesia, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Mohan V R
authors.initials: MV
authors.lastname: Chadalawada
authors.affiliation: Department of Anaesthesia, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Ajish Varghese
authors.initials: AV
authors.lastname: Cheruvathoor
authors.affiliation: Department of Anaesthesia, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Yatish
authors.initials: Y
authors.lastname: Bevinguddaiah
authors.affiliation: Department of Anaesthesia, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Nirmal
authors.initials: N
authors.lastname: Sheshagiri
keywords: Bispectral index; dexmedetomidine; epidural anesthesia; general anesthesia; propofol; ropivacaine