Dexmedetomidine in Obturator Nerve Block as an Analgesic in Transurethral Surgeries

Early Phase 1CompletedNCT06229054

Cairo University56 enrolled

Overview

in our study, we will investigate the impact of adding dexmedetomidine to bupivacaine for the potency of the obturator nerve block and prevention of the postoperative pain associated with transurethral surgery in comparison of obturator nerve block with bupivacaine alone

* After history taking and examination of the labs and airway of the patient , An intravenous catheter will be secured in the dorsum of the hand of non dominant hand and patients will be monitored for heart rate, noninvasive blood pressure, and oxygen saturation. * All patients after aseptic preparation will receive subarachnoid block in lumber 3-4 or 4-5 space in sitting position. * About 3 ml (15mg) of heavy 0.5% bupivacaine will be injected into subarachnoid space. * After the completion of the block, patients will be laid in the supine position and subsequently waited for 5 min for fixation of drug and assessed for sensorimotor block. * Further procedure will be performed as per the group allocation. * ONB will be performed by classic technique 1.5cm lateral and 1.5cm caudal to the pubic tuberacle . after contact with the pubic ramus is made , the needle is redirected laterally to a point 2-3 cm deeper than the pubic ramus.(15) * A waiting period 20 min will be allowed for the full effect of the block and then resection will be allowed to perform * Hemodynamics (heart rate, mean arterial blood pressure) will be recorded intraoperatively and postoperative at 0, 2 and 6 hours . * VAS score at 0,2 and 6 hours post-operatively will be assessed. * Time to first call for analgesic requirements (duration of analgesia) will be measured. * Total postoperative analgesic consumption in the first 24 hours post-operative will be measured. * Incidence of complications such as nerve injury, hematoma formation, local anesthetic toxicity, intravascular injection, bleeding and bladder perforation will be assessed.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

Conditions

Dexmedetomidine

Interventions

DexmedetomidineDRUG

Dexmedetomidine (DEX), an α2-agonist with more promising pharmacokinetic and pharmacodynamic characteristics than clonidine has been proved to have a positive effect on postoperative pain intensity and to reduce opioid consumption

Bupivacaine HydrochlorideDRUG

local anesthesic which works through blocking sodium channels

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Participants will be adults (above 18 years) scheduled to undergo transurethral surgery under regional anesthesia. * ASA1, ASA2 Exclusion Criteria: * American Society of Anesthesiologists (ASA) physical class 3,4, severe cardiac comorbidity (impaired contractility with ejection fraction less than 50%, heart block, significant arrhythmias, tight valvular lesions), allergy to any study's drugs

Locations (1)

Faculty of Medicine-Cairo Univeristy

Cairo, Egypt

Outcomes

Primary Outcomes

Severity of pain measured by visual analog scale (VAS) score. postoperative pain after transurethral surgeries

the VAS score consists of 10cm line where 0 represents NO PAIN and 10 represents SEVEREST FORM OF PAIN

Time frame: 24 hours postoperatively

Secondary Outcomes

• Perioperative analgesic consumption, which will be calculated as the total amount of opioids administered in the postoperative periods.

to detect incidence of pain postoperative

Time frame: 24 hours postoperative

• Incidence of adverse effects as bleeding and bladder perforation.

to detect any complications occured during the surgery

Time frame: 24 hours postoperative

• Incidence of adductor jerk reflex

to detect incidience of jerk reflex during the surgery

Time frame: intraoperative

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.