preoperative melatonin, pregabalin or both will be given to all patients preoperative
On arrival at the operating room, continuous electrocardiogram, non-invasive blood pressure and pulse oximetry monitors will be applied. Sedation score (ramsay sedation score)(10) will be recorded on arrival to OR An 18-gauge cannula will be inserted in a peripheral vein and a warmed (37°C) lactated Ringer solution infusion was started. Ondansetron 4 mg will be administered intravenously as a prophylaxis against nausea and vomiting. Thereafter the patient will be supported in the sitting position. Intrathecal anaesthetic (room temperature hyperbaric bupivacaine 0.5% (20 mg) + fentanyl 25 μg (0.5 mL) will be given under complete aseptic technique . The patient was returned to the supine position for 15 min then to lateral position with operative side up. HR and blood pressure will be measured every 2.5 minutes intraoperatively, however, the values will be recorded in the anesthesia chart only every five minutes for 2 hours then every 15 minutes for 3 hours. Durations will be calculated considering the time of spinal injection as time zero. Hypotension (SAP\<100 mmHg or \<80% of the baseline measured before spinal anaesthesia) will be treated by ephedrine 6 mg, to be repeated if inadequate response within 2 minutes. If bradycardia (HR≤60 bpm) developed, atropine (0.6 mg) will be given to restore adequate HR (≥60 bpm).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
TRIPLE
Enrollment
78
In the night before surgery, 90 minutes before administering the intrathecal anesthesia and 12 hr after surgery
In the night before surgery, 90 minutes before administering the intrathecal anesthesia and 12 hr after surgery
before spinal anaesthesia
Faculty of Medicine, University Hospitals
Shibīn al Kawm, Menoufia, Egypt
VAS
change of VAS of the patient on a scale from the night before surgery
Time frame: on arrival to operating room then every 6 hours untill 48 hours
Ramsey Sedation scale
change of sedation of the patient on a scale from the night before surgery
Time frame: on arrival to operating room then every 6 hours untill 48 hours
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