Morphine and Dexmedetomidine as Adjuvants to Bupivacaine in Ultrasound-guided Erector Spinae Plane Block for Open Subcostal Renal Surgeries

Kafrelsheikh University147 enrolled

Overview

This study aimed to compare the analgesic efficacy between morphine and dexmedetomidine as adjuvants to bupivacaine in ultrasound-guided erector spinae plane block for open subcostal renal surgeries.

The postoperative pain that occurs because of the wide flank incision ranges from a moderate to severe intensity and, in some patients, can become chronic. The erector spinae plane block (ESPB) is a novel interfascial plane technique, aiming to block the dorsal and ventral rami of the spinal nerves to provide visceral and somatic multi-dermatomal analgesia of the cervical, thoracic, and lumbar levels. Adjuvants to local anesthetics, such as morphine and dexmedetomidine, can be used to improve the quality and duration of peripheral nerve block effects.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

147

Conditions

Morphine Dexmedetomidine Adjuvants Bupivacaine

Interventions

MorphineDRUG

Patients received erector spinae plane block with morphine 2 mg as an adjuvant to bupivacaine 30 ml 0.25%.

DexmedetomidineDRUG

Patients received erector spinae plane block with dexmedetomidine 100 µg as an adjuvant to bupivacaine 30 ml 0.25%.

Erector spinae plane blockOTHER

Patients received erector spinae plane block with bupivacaine 30 ml 0.25% only.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patient's approval. * Age: 20 - 65 years. * Physical Status: American Society of Anesthesiologists (ASA) I \& II. * Patients undergoing open subcostal renal surgeries. Exclusion Criteria: * Patient refusal. * Age: \>65 and \<20 years. * Allergy to Dexmedetomidine, local anesthetics, systemic opioids, and any of the drugs included in the multimodal perioperative pain protocol. * Patient with coagulation disorders. * Chronic pain syndromes and patients with chronic opioid use are defined as use of regular daily doses of systemic narcotics for the past 6 months before the surgery. * Body mass index of 35 kg/ m2 or more. * Physical Status: American Society of Anesthesiologists (ASA) III \& IV. * Local infection or sepsis at the site of injection.

Outcomes

Primary Outcomes

Degree of pain

The degree of pain was assessed using the Visual analogue scale (VAS) \[where (0 = no pain and 10 = severe pain)\]. VAS was evaluated at 0, 2, 4, 6, 8, 12, 18, and 24 hours postoperatively.

Time frame: 24 hours postoperatively

Secondary Outcomes

Duration of sensory block

Duration of sensory block was assessed.

Time frame: Intraoperatively

Time to first rescue analgesia

Time to first rescue analgesia was assessed from the end of surgery till first dose of pethidine administrated.

Time frame: 48 hours postoperatively

Total opioid consumption

If the Visual analogue scale (VAS) is ≥ 3, intravenous pethidine was given (0.5mg/kg).

Time frame: 48 hours postoperatively

Heart rate

Heart rate was recorded at baseline, after injection then every 30 min till the end of surgery and after surgery at 0, 2, 4, 6, 8, 12, 24 and 48 h.

Time frame: 48 hours postoperatively

Mean arterial pressure

Mean arterial pressure was recorded at baseline, after injection then every 30 min till the end of surgery and after surgery at 0, 2, 4, 6, 8, 12, 24 and 48 h.

Time frame: 48 hours postoperatively

Morphine and Dexmedetomidine as Adjuvants to Bupivacaine in Ultrasound-guided Erector Spinae Plane Block for Open Subcostal Renal Surgeries

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes