Epidural Analgesics for Comparison
Conditions
Keywords
epidural, dexmedetomidine, microscopic lumber discectomy
Brief summary
The goal of this observational study is to compare the effectiveness and patient satisfaction of local anesthesia combined with intravenous Dexmedetomidine versus epidural anesthesia in endoscopic lumbar discectomy surgeries
Detailed description
In recent years, with the development of medical instruments, minimally invasive surgical methods for lumbar disc herniation became increasingly popular, such as percutaneous transforaminal endoscopic discectomy (PTED) PTED under local anesthesia (LA) is recommended in consideration of safety. Under LA, patients keep conscious during the procedure, and the surgeon can obtain feedback directly from the patients if the nerve is interfered. However, in clinical practice, we found that many patients couldn't tolerate the pain during operation especially when placing the working channel Dexmedetomidine, a highly selective alpha 2 adrenoreceptor agonist, has unique characteristics in providing sedation and analgesia. Due to its central sympatholytic action, DEX produces dose-dependent sedation, antinociception and anxiolysis, while decreasing intraoperative hypertension and tachycardia episodes Epidural anesthesia is another major method which can keep patients awake during surgery and the surgeons can check the function of the nerve from the maintained motor function of patients' lower limbs
Interventions
None listed
Sponsors
Egyptian Center for Research and Regenerative Medicine
Ain Shams University
Study design
Observational model
OTHER
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Patients American Society of anesthesiologists' physical status (ASA) I to II. 2. Aged 18 to 60 years. 3. Both sexes. 4. Patients with clinical and radiological evidence of soft disc herniation in a single lumber segment.
Exclusion criteria
1. Spinal malformation 2. Recurrent lumber disc herniation (LDH) 3. Multi segment LDH 4. Patients younger than 18 years or older than 60 years 5. Patients with hypersensitivity to one of the used drugs 6. Patients suffering of coagulopathy 7. Operation time more than 1 hour
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| we compare numerical rating pain score (NRS) between the two groups immediately at foraminal dilatation maneuver | from January 2021 to January 2024 | It refers to the common method used in healthcare where patients rate their pain on a scale from 0 to 10: 0 = No pain 10 = Worst pain imaginable. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Heart rate (H.R) | from January 2021 to January 2024 | We compare the heart rate ( by beats per minute) in the 2 groups every 10 minutes intraoperative |
| Mean arterial blood pressure (MABP) | from January 2021 to January 2024 | we compare mean arterial blood pressure between the 2 groups by millimeter of mercury (mmhg) every 10 minutes intraoperative |
| we compare Bromage scale in the two groups intraoperative during foraminal dilatation by the surgeon | from January 2021 to January 2024 | It is a clinical tool used to assess motor function in the lower limbs following epidural or spinal anesthesia (from 0 to 3) 0 means full movement (no motor blockage) 3 means complete motor block - unable to move feet, legs, or raise leg. |
Countries
Egypt
Outcome results
None listed