Analgesic Efficacy of Dexmedetomidine Added to Fentanyl in PCEA

South Egypt Cancer Institute90 enrolled

Overview

Dexmedetomidine if add to patient controlled epidural analgesia for patients undergoing major abdominal cancer surgery may improve its effects.

The aim of modern anaesthetic practice is to insure the rapid recovery of patients with fewer complications and earlier hospital discharge. Thoracic epidural anesthesia (TEA) has been established as a cornerstone in the perioperative care after thoracic and major abdominal surgery providing most effective analgesia. beyond its analgesic properties, TEA's effects on the postoperative neurohumoural stress response, cardiovascular Pathophysiology, and intestinal dysfunction have been in the focus of both clinical and experimental investigations for years. dexmedetomidine if add to patient controlled epidural analgesia for patients undergoing major abdominal cancer surgery may improve its effects.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

TRIPLE

Enrollment

Conditions

Abdominal Pain Abdominal Cancer

Interventions

TEA+DEXPROCEDURE

intra and post operative TEA infusion of (bupivacaine +fentanyl 2 mic/ ml+ dexmedetomidine 0.5 mic/ ml) Under strict aseptic precautions thoracic epidural was performed using a 16 gauge,Tuhy epidural needle by a paramedian approach. T8-T9 inter space was chosen for the injection. Skin at insertion site was anesthetized by 3 ml of lidocaine 1%, the epidural space was identified by the loss of resistance technique, the catheter was introduced approximately 2-4 cm into the epidural space, epidural test dose consisted of 3 ml of lidocaine 2 % with 1: 200,000 adrenaline.

TEAPROCEDURE

Under strict aseptic precautions thoracic epidural was performed using a 16 gauge,Tuhy epidural needle by a paramedian approach. T8-T9 interspace was chosen for the injection. Skin at insertion site was anesthetized by 3 ml of lidocaine 1%, the epidural space was identified by the loss of resistance technique, the catheter was introduced approximately 2-4 cm into the epidural space, epidural test dose consisted of 3 ml of lidocaine 2 % with 1: 200,000 adrenaline. then, intra and post operative TEA infusion of bupivacaine 0.125%+fentanyl 2 mic/ ml.

Eligibility

Sex: ALLMin age: 21 Years

Medical Language ↔ Plain English

Inclusion Criteria: * adult patients (21 years old or more), * classified as American Society of Anesthesiologists (ASA) grade II and III, * scheduled for elective major abdominal cancer surgery. Exclusion Criteria: * patients with coagulopathy, * active neurological disease, * cutaneous disorders at the epidural insertion site, * allergy to the study medication * and patients refusal.

Locations (1)

South Egypt Cancer Institute, Assiut University, Arab Republic of Egypt

Asyut, Egypt

Outcomes

Primary Outcomes

Change in pain scores (dynamic VAS)

dynamic visual analogue scale (0-10) 0=no pain 10=worst imaginable pain

Time frame: at 0, 4, 8, 12, 18, 24, 36 and 48 hours post operative.

Secondary Outcomes

Change in post operative MAP

Mean arterial pressure

Time frame: at 0, 4, 8, 12, 18, 24, 36 and 48 hours post operative.

Data from ClinicalTrials.gov

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