Abdominal Pain, Abdominal Cancer
Conditions
Brief summary
Dexmedetomidine if add to patient controlled epidural analgesia for patients undergoing major abdominal cancer surgery may improve its effects.
Detailed description
The aim of modern anaesthetic practice is to insure the rapid recovery of patients with fewer complications and earlier hospital discharge. Thoracic epidural anesthesia (TEA) has been established as a cornerstone in the perioperative care after thoracic and major abdominal surgery providing most effective analgesia. beyond its analgesic properties, TEA's effects on the postoperative neurohumoural stress response, cardiovascular Pathophysiology, and intestinal dysfunction have been in the focus of both clinical and experimental investigations for years. dexmedetomidine if add to patient controlled epidural analgesia for patients undergoing major abdominal cancer surgery may improve its effects.
Interventions
PROCEDURETEA+DEX
intra and post operative TEA infusion of (bupivacaine +fentanyl 2 mic/ ml+ dexmedetomidine 0.5 mic/ ml) Under strict aseptic precautions thoracic epidural was performed using a 16 gauge,Tuhy epidural needle by a paramedian approach. T8-T9 inter space was chosen for the injection. Skin at insertion site was anesthetized by 3 ml of lidocaine 1%, the epidural space was identified by the loss of resistance technique, the catheter was introduced approximately 2-4 cm into the epidural space, epidural test dose consisted of 3 ml of lidocaine 2 % with 1: 200,000 adrenaline.
PROCEDURETEA
Under strict aseptic precautions thoracic epidural was performed using a 16 gauge,Tuhy epidural needle by a paramedian approach. T8-T9 interspace was chosen for the injection. Skin at insertion site was anesthetized by 3 ml of lidocaine 1%, the epidural space was identified by the loss of resistance technique, the catheter was introduced approximately 2-4 cm into the epidural space, epidural test dose consisted of 3 ml of lidocaine 2 % with 1: 200,000 adrenaline. then, intra and post operative TEA infusion of bupivacaine 0.125%+fentanyl 2 mic/ ml.
Sponsors
South Egypt Cancer Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* adult patients (21 years old or more), * classified as American Society of Anesthesiologists (ASA) grade II and III, * scheduled for elective major abdominal cancer surgery.
Exclusion criteria
* patients with coagulopathy, * active neurological disease, * cutaneous disorders at the epidural insertion site, * allergy to the study medication * and patients refusal.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in pain scores (dynamic VAS) | at 0, 4, 8, 12, 18, 24, 36 and 48 hours post operative. | dynamic visual analogue scale (0-10) 0=no pain 10=worst imaginable pain |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in post operative MAP | at 0, 4, 8, 12, 18, 24, 36 and 48 hours post operative. | Mean arterial pressure |
Countries
Egypt
Outcome results
None listed