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The Effect of Dexmedetomidine, Melatonin and Pregabalin

Early Phase 1
Not yet recruiting
Conditions
Endoscopic Sinus Surgery
Interventions
Registration Number
NCT05829148
Lead Sponsor
Egymedicalpedia
Brief Summary

Various drugs have been used for the purpose: nitroglycerine, sodium nitroprusside, propofol, beta blockers, calcium channel blockers, higher concentrations of inhalational anesthetics etc. Since all these drugs have certain limitations there was a search for more safe and effective drug

Detailed Description

Functional Endoscopic Sinus Surgery (FESS) is done via endoscope and the area is highly vascular thus it becomes important to minimize bleeding, hence we require hypotensive anesthesia.

Dexmedetomidine (a highly selective α2-receptor agonist that has sedative, analgesic, anxiolytic, and opioid sparing effects without significant respiratory depression) it also reduces the need for inhaled anesthetics. dexmedetomidine also minimizes postoperative opioid consumption as well as nausea, vomiting, and anxiety.

Melatonin is a neurohormone mainly secreted from the pineal gland by the suprachiasmatic nucleus. It possesses a circadian secretion pattern and regulates the biological clock; it also offers antiemetic, analgesic, and anxiolytic effects. Due to its effect on both acute and chronic pain, melatonin (available in 5mg tablet form) fulfills a beneficial role in reducing postoperative opioid consumption while minimizing nausea and vomiting.

Pregabalin, whose structure is similar to the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), possesses analgesic and anxiolytic activities and is effective in alleviating the neuropathic component of acute nociceptive pain of surgery. It has also been used as premedication to attenuate the hemodynamic stress response to laryngoscopy and intubation and to decrease intraoperative anesthetic requirement

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
120
Inclusion Criteria
  • Patients undergoing Functional endoscopic sinus surgery (ASA I & II)
Exclusion Criteria
  • Hepatic, renal, endocrinal, hematological disorders.
  • BMI>30 kg/m2.
  • Patients receiving magnesium supplementation, anticonvulsant drugs or antipsychotic drugs.
  • Chronic use of opioids.
  • Current treatment with β-blocker or calcium channel blocker.
  • Known allergies to any of study drugs.
  • Patients refusal to the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control GroupPlaceboThis Group about 30 patients will receive oral starch tablet as a control. Heart rate (HR) and blood pressure values will be recorded at various intervals.
Dexmedetomidine GroupDexmedetomidineThis Group about 30 patients will receive dexmedetomidine loading dose 1 µg/kg over a period of 15 minutes and maintenance 0.2µg/kg/h throughout the surgery .
Melatonin GroupMelatoninThis Group about 30 patients will receive 10 mg melatonin (2 tablets) one hour before starting of the operation.
Pregabalin GroupPregabalinThis Group about 30 patients will receive oral pregabalin 150 mg one hour before starting of the operation..
Primary Outcome Measures
NameTimeMethod
Pain Relieve2 hours post operative

Assessment of the pain post-operatively in patients with pain score by VAS as : Total scores vary from 0 to 10 in this method, with a higher score indicating more severe pain,

Secondary Outcome Measures
NameTimeMethod
controlled blood pressureFrom base line to 1 hour after the end of the operation

Hemodynamics stability

controlled pulse rateFrom base line to 1 hour after the end of the operation

Hemodynamics stability

Trial Locations

Locations (1)

Al-Azhar University hospitals

🇪🇬

Cairo, Egypt

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