Adjuvants, Bupivacaine, Dexmedetomidine, Erector Spinae Plane Block, Morphine, Open Subcostal Renal Surgeries, Ultrasound
Conditions
Brief summary
This study aimed to compare the analgesic efficacy between morphine and dexmedetomidine as adjuvants to bupivacaine in ultrasound-guided erector spinae plane block for open subcostal renal surgeries.
Detailed description
The postoperative pain that occurs because of the wide flank incision ranges from a moderate to severe intensity and, in some patients, can become chronic. The erector spinae plane block (ESPB) is a novel interfascial plane technique, aiming to block the dorsal and ventral rami of the spinal nerves to provide visceral and somatic multi-dermatomal analgesia of the cervical, thoracic, and lumbar levels. Adjuvants to local anesthetics, such as morphine and dexmedetomidine, can be used to improve the quality and duration of peripheral nerve block effects.
Interventions
DRUGMorphine
Patients received erector spinae plane block with morphine 2 mg as an adjuvant to bupivacaine 30 ml 0.25%.
DRUGDexmedetomidine
Patients received erector spinae plane block with dexmedetomidine 100 µg as an adjuvant to bupivacaine 30 ml 0.25%.
OTHERErector spinae plane block
Patients received erector spinae plane block with bupivacaine 30 ml 0.25% only.
Sponsors
Kafrelsheikh University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Patient's approval. * Age: 20 - 65 years. * Physical Status: American Society of Anesthesiologists (ASA) I & II. * Patients undergoing open subcostal renal surgeries.
Exclusion criteria
* Patient refusal. * Age: \>65 and \<20 years. * Allergy to Dexmedetomidine, local anesthetics, systemic opioids, and any of the drugs included in the multimodal perioperative pain protocol. * Patient with coagulation disorders. * Chronic pain syndromes and patients with chronic opioid use are defined as use of regular daily doses of systemic narcotics for the past 6 months before the surgery. * Body mass index of 35 kg/ m2 or more. * Physical Status: American Society of Anesthesiologists (ASA) III & IV. * Local infection or sepsis at the site of injection.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Degree of pain | 24 hours postoperatively | The degree of pain was assessed using the Visual analogue scale (VAS) \[where (0 = no pain and 10 = severe pain)\]. VAS was evaluated at 0, 2, 4, 6, 8, 12, 18, and 24 hours postoperatively. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of sensory block | Intraoperatively | Duration of sensory block was assessed. |
| Time to first rescue analgesia | 48 hours postoperatively | Time to first rescue analgesia was assessed from the end of surgery till first dose of pethidine administrated. |
| Total opioid consumption | 48 hours postoperatively | If the Visual analogue scale (VAS) is ≥ 3, intravenous pethidine was given (0.5mg/kg). |
| Heart rate | 48 hours postoperatively | Heart rate was recorded at baseline, after injection then every 30 min till the end of surgery and after surgery at 0, 2, 4, 6, 8, 12, 24 and 48 h. |
| Mean arterial pressure | 48 hours postoperatively | Mean arterial pressure was recorded at baseline, after injection then every 30 min till the end of surgery and after surgery at 0, 2, 4, 6, 8, 12, 24 and 48 h. |
Countries
Egypt
Outcome results
None listed