A comparative study of bupivacaine 0.25% alone and with fentanyl or dexmedetomidine for Percutaneous nephrolithotomy (PCNL) under epidural anaesthesia

Low concentration of bupivacaine has been used to provide perioperative analgesia. This study was undertaken to compare low concentration bupivacaine (0.25%) when given alone and with fentanyl (17μg/kg) or dexmedetomidine (1μg/kg) in epidural anaesthesia in patients undergoing PCNL. Sensory and motor blocks were more pronounced in the dexmedetomidine group along with superior sedation. None of the patients in the study had any major complication and surgery underwent smoothly without requirement of general anaesthesia. From our study, it can be concluded that PCNL can be performed using 0.25% bupivacaine as epidural anaesthetic agent. Further, dexmedetomidine is a better adjuvant than fentanyl in epidural anaesthesia. Dexmedetomidine combined with 0.25% of bupivacaine in epidural anaesthesia provides adequate operating conditions for PCNL with minimal motorblockade.