Cervical Spine Surgery
Conditions
Brief summary
Posterior cervical spine surgery often requires a large posterior midline incision, resulting in poorly controlled postoperative pain, which arises from iatrogenic mechanical damage, intraoperative retraction, and resection to structures such as bone, ligaments, muscles, intervertebral discs, and zygapophysial joints.
Detailed description
Ultrasound-guided Inter-semispinal plane (ISP) block, was proposed as a novel technique for analgesia in posterior cervical spine surgeries. The ISP block involves an injection of local anesthetic into the fascial plane between the semispinalis cervicis and semispinal capitis muscles and results in blocking the dorsal rami of the cervical spinal nerves. ISP block can provide effective analgesia in posterior cervical spine surgery
Interventions
PROCEDUREInter-semispinal plane block
Ultrasound Inter-semispinal plane block in block group
Sponsors
Zagazig University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Masking description
Randomization assignments will be kept in sealed envelopes until all preprocedural measurements will be completed, and then they are opened by the research anesthesiologist immediately prior to the nerve block.
Intervention model description
This study will be performed in neurosurgical operating rooms at Zagazig University Hospitals and included 52 patients allocated randomly into two groups: 26 patients recruited in the block group (I) for the Inter-semispinal plane block and 26 patients recruited in the (C) control group.
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Patients' acceptance. * ASA I , II andIII . * Age between 18 years up to 70 years in both sexes. * Patients with a BMI (body mass index) ranging from 18.5 to 30 kg/m2. * Patients who scheduled for elective posterior cervical spine surgeries
Exclusion criteria
* Uncooperative patients * Coagulopathy. * Local tissue infection. * Allergy to local anesthesia.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total morphine consumed for 24 hours postoperative will be calculated. | Total morphine consumed up to 24 hours postoperative | Calculation of total morphine that will be used postoperatively. Postoperative morphine will be considered if the postoperative VAS score \>3 or the patient requested additional analgesia. Rescue analgesia of intravenous morphine will be given |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total fentanyl consumed intraoperative will be calculated | total fentanyl dose that will be used for entire operative time. | Total intraoperative fentanyl consumption including the induction doses (1mic/ kg) plus the additional doses of fentanyl (from 0.5 to 1 mic) that will be given if heart rate or blood pressure increases above 20%. |
| postoperative pain will be assessed using the Numerical Pain Score (NRS) score | NRS will be recorded 24 hours postoperative. | Numerical Pain Score (NRS) ranges from 0 to 10, where 0 is no pain, and 10 is the worst pain imaginable. Adequate pain control will be considered at Numerical Pain Score (NRS) \< 4. |
Countries
Egypt
Outcome results
None listed