Hip Osteoarthritis, Hip Arthropathy, Hip Pain Chronic
Conditions
Brief summary
Effect of perineurial dexamethasone and dexmedetomidine on erector spinal plane block duration for hip arthroplasty
Detailed description
This study is proposed to explore the effect of perineurial Dexamethasone and Dexmedetomidine on erector spinal plane block duration for spine surgery. After spine surgery, patients need good analgesia. Peripheral nerve blocks have provided a safe, effective method to control early postoperative pain when symptoms are most severe. The safety of local anaesthesia is essential due to the much lower toxicity threshold of local anaesthetics. An effective adjuvant, such as Dexamethasone or Dexmedetomidine, could allow for a higher dilution of local anaesthetics while maintaining and enhancing their analgesic effect. There is considerable research where intravenous and perineural dexamethasone and Dexmedetomidine use have been compared in adults. However, there is a massive lack of research regarding spine surgery and the Erector Spinae Plane Block. In this study, investigators compare perineural Dexamethasone and Dexmedetomidine. The investigator aims to find a dexamethasone or dexmedetomidine that covers the need for good pain relief and fast recovery postoperatively.
Interventions
unilateral administration of 20ml of 0,2% ropivacaine + 2ml 0.9% sodium chloride for the erector spine plane block
unilateral administration of 20ml of 0,2% ropivacaine with 4mg Dexamethasone for the erector spine plane block
unilateral administration of 20ml of 0,2% ropivacaine with 50ug Dexmedetomidine for the erector spine plane block
Sponsors
Study design
Eligibility
Inclusion criteria
* patients undergoing primary hip arthroplasty * aged \>18 years and \<100 years * ASA physical status 1, 2 or 3.
Exclusion criteria
* if they refused to participate, * had a history of opioid abuse, * had an infection of the site of needle puncture, * were less than 18 years of age, * were postponed as having ASA 4 or 5, * had an allergy to any of the drugs used in the study, * renal failure (estimated glomerular filtration rate \<15ml/min/1.73m2), * liver failure, * known or suspected coagulopathy, * pre-existing anatomical or neurological disorders in the lower extremities, * intellectual disability with problems in pain evaluation, * severe psychiatric illness.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| first need of opiate | 48 hours after surgery | Time after surgery when the patient needs opiate for the first time |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Opioid consumption | 48 hours after surgery | Total opiate consumption after surgery |
| Numerical Rating Scale [range 0:10] | 4 hours after surgery | NRS (Numerical Rating Scale; 0 - no pain; 10 - the worst pain ever) |
| NLR | 48 hours after surgery | Neutrophil-to-lymphocyte ratio |
| PLR | 48 hours after surgery | Platelet-to-lymphocyte ratio |
Countries
Poland