Postoperative Pain
Conditions
Keywords
analgesia, intrathecal, opioids, morphine, dexmedetomidine
Brief summary
The current study investigated the effect of adding dexmedetomidine to intrathecal morphine for postoperative analgesia in cancer patients undergoing major abdominal surgery.
Detailed description
Opioids, administered intrathecal or epidural, are widely used for postoperative, and chronic nociceptive pain secondary to cancers. Intrathecal injection of morphine to provide postoperative analgesia during the initial 24 h after operation is a widely used technique.The Human studies on the antinociceptive effects of co-administrated intrathecal morphine and dexmedetomidine in postoperative pain are still lacking. In this study, the investigators aimed to compare the synergistic interaction and side-effects of combined intrathecal morphine and dexmedetomidine with either drug alone for postoperative analgesia in cancer patients undergoing major abdominal surgery. Patients were randomly allocated into three groups of 30 patients each to receive either; hyperbaric bupivacaine 0.5% (Group I/Bupivacaine Group), bupivacaine and 0.5 mg morphine (Group II/Morphine Group), bupivacaine and 0.5 mg morphine plus 5 µg of dexmedetomidine (Group III/Morphine-DEX Group). The assigned drugs were dissolved in 1ml physiological saline and administered intrathecal with bupivacaine before induction of general anesthesia.
Interventions
DRUGBupivacaine
intrathecal 10 mg bupivacaine
DRUGMorphine
intrathecal 0.5mg morphine
intrathecal administration
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
30 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
\- major abdominal cancer surgery (e.g. hemi-colectomy or cystectomy)
Exclusion criteria
* known allergy to study drugs * Significant cardiac, respiratory, renal or hepatic disease. * 2nd or 3rd degree heart block. * Coagulation disorders. * Low back pain or other back problems. * Drug or alcohol abuse. * BMI\>30kg\\m2. * Psychiatric illnesses that would interfere with perception and assessment of pain.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| total dose of intravenous PCA morphine consumption in the first 48 h postoperative | 48 hours | Calculating the cumulative intravenous PCA morphine dose |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Noninvasive blood pressure | 48 hours | non invasive systolic and diastolic blood pressure intra-operative and postoperative in the 6th, 12th, 18th, 24th, 36th, and 48th h postoperative. |
| Heart rate | 48 hours | non invasive assessment of heart rate in the 6th, 12th, 18th, 24th, 36th, and 48th postoperative. intraoperative and postoperative |
| peripheral arterial oxygen saturation | 48 hours | assessment of pulse oximetry intraoperative and in the 6th, 12th, 18th, 24th, 36th, and 48th h postoperative |
| postoperative VAS scores | 48 hours | assessment of pain scores on admission to surgical intensive care unit and in the 6th, 12th, 18th, 24th, 36th, and 48th h postoperative. |
| time to first request for analgesia | 48hours | measuring the time in hours of first request for intravenous PCA morphine |
Outcome results
None listed