Postoperative Pain, Acute
Conditions
Brief summary
This current comparative study involved 54 patients undergoing thoracoscopic thymectomy who were distributed randomly into three equal groups to receive ultrasound (US)-guided ESPB using 20 ml bupivacaine 0.25% (group B) , 20 ml bupivacaine 0.25% with 8 mg dexamethasone (group BS), 20 ml bupivacaine 0.25% with dexmedetomidine 1mcg/kg (group BM). The time till the first postoperative rescue analgesic requested was the primary outcome. The secondary outcomes included the postoperative pain scores and analgesic consumption.
Interventions
PROCEDUREErector Spinae Plane Block
An echogenic 21 gauge 10 cm needle was introduced in caudo-cephalic orientation utilizing the in-plane approach and traversing through trapezius, rhomboid, and erector spinae muscles till reaching the transverse process then slightly withdrawn and hydrodissection was done by 3 mL of saline 0.9% to verify the accurate implantation of the block needle tip between the erector spinae muscle and the transverse process (the erector spinae plane). Incremental LA injection was verified through US observation for the upward displacement and lifting of erector spinae muscle from the transverse process with craniocaudal spread of the LA in the targeted plane. The LA increments were one ml every 5 seconds with intermittent aspiration every 5 mL to avoid intravascular injection.
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* myasthenic patients * American Society of Anesthesiologists (ASA) physical grade of 2-3) * who underwent video assisted thoracoscopic thymectomy
Exclusion criteria
* Refused participation in the study, * known allergy for this study drugs , * Contraindication to the ESPB as infection at block site \& marked chest cage deformity, * significant bleeding disorders , * patients with significant renal or liver dysfunction, * heart block , * poor ventilatory function, * severe chronic obstructive pulmonary disease, * morbid obesity, * mental disability, or communication difficulties that hindered effective pain assessment, * Individuals who was converted to open thoracotomy or those re-explorated for surgical related issues.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| the duration between the surgery end and the 1st rescue analgesia the patient requested. | 24 hours postoperatively |
Secondary
| Measure | Time frame |
|---|---|
| .Total ketorolac consumption | 24 hours postoperatively |
| . Number of patients needed rescue tramadol | 24 hours postoperatively |
Contacts
CONTACTRamy Mahrose
Outcome results
None listed