Comparison of analgesic efficacy of dexamethasone and dexmedetomidine as adjuvants to ropivacaine in ultrasound guided retrolaminar block for adult patients undergoing thoracolumbar spine surgery: a randomized controlled trial

In the landscape of thoracolumbar spine surgeries, effective perioperative pain management stands as a pivotal element in controlling post operative pain and optimizing pain relief allowing for early ambulation and decreased hospital stay. A wide of number of regional analgesia techniques have been utilised to manage this pain like paravertebral blocks, epidural blocks and interfascial blocks like erector spinae plane block.

Retrolaminar block (RLB) is a novel interfacial plane block which has been used to provide perioperative analgesia in patient undergoing lumbar surgeries, breast surgeries, nephrectomy, thoracotomy and in retroperitoneal laproscopic surgeries.  In all of these studies only local anaesthetic (bupivacaine or ropivacaine) was used. These local anaesthetics have limited duration of action typically, around 10 hours.  Several drugs (opioids, dexamethasone) have been used as adjuvants to local anaesthetics to prolong the duration of analgesia in erector spinae plane block for spine surgeries.

However, the efficacy of these adjuvants has not been established in retrolaminar plane blocks. Our study aims to determine the benefits of adding dexmedetomidine or dexamethasone as adjuvant to ropivacaine in prolonging the duration of postoperative analgesia, improve postoperative pain score and patient satisfaction.