The aim and objective of this study is to compare dexmedetomidine and fentanyl as adjuvants to bupivacaine in ultrasound guided TAP block analgesia in patients undergoing radical cystectomy as regarding postoperative analgesic efficacy.
Radical cystectomy with pelvic lymph node dissection is the gold standard treatment for muscle invasive bladder cancer and is associated with a high risk of complications. Management of the postoperative pain is important to decrease the length of stay in the hospital and the risk of morbidity. Multimodal analgesia management is utilized for pain observed in the postoperative period.As part of a multimodal analgesic regimen, a peripheral nerve block can decrease opioid consumption, providing more effective analgesia with fewer adverse effects.TAP block is a relatively new regional anesthesia technique that provides analgesia to the parietal peritoneum, as well as skin and muscles of the lower anterior abdominal wall. Dexmedetomidine and fentanyl have been used as adjuvants to local anesthetics in different surgeries to provide superior analgesia and to improve the duration of the block.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
60
single shot US guided TAP block using 20 ml bupivacaine 0.25%.
Single shot US guided TAP block using 20 ml bupivacaine 0.25% + 50 µg dexmedetomedine on each side.
Single shot US guided TAP block using 20 ml bupivacaine 0.25% + 50 µg fentanyl on each side.
The time for first rescue analgesia after the TAP block.
Postoperative analgesia duration.
Time frame: first 24 hours after block.
the total dose of rescue analgesia after TAP bock.
Postoperative analgesia consumption.
Time frame: first 24 hours after block.
VAS for pain.
Postoperative pain at rest and movement.
Time frame: 0, 2, 4, 6, 12 and 24 hours postoperatively.
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