Effect of Intrathecal Morphine, Dexmedetomidine or Both in Combination to Bupivacaine on Immunity
- Conditions
- Immune System Suppression
- Interventions
- Registration Number
- NCT03024957
- Lead Sponsor
- Assiut University
- Brief Summary
this work aims to investigate the effect of intrathecal administration of Morphine, Dexmedetomidine or both in combination on cellular immunity and cytokine production in patients undergoing major abdominal cancer surgeries.
- Detailed Description
Intrathecal (IT) adjuvants prolong the duration of spinal anesthesia and postoperative analgesia thereby reducing the requirement of postoperative supplemental analgesics. The incorporation of adjuvants also lowers the overall dose of local anesthetic and hence associated side effects. Morphine has been used widely to alleviate various types of pain and to supplement general anesthesia. On the other hand, morphine has been reported to possess some immunosuppressive effects. Postoperative immunity is also important in conjunction with defence against malignant tumour. Dexmedetomidine is a highly selective α2 agonist with analgesia, sedation, anxiolysis, and sympatholysis as its useful pharmacological actions. The extended analgesic efficacy of IT dexmedetomidine (ITD) in the postoperative period has been shown in a few clinical studies. In addition, current insights have identified that dexmedetomidine has a capacity in inhibiting the overproduction of a variety of inflammatory molecules including TNF-α, IL-1β, and IL-6 in several acute inflammatory animal models.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 30
- ASA I-II patients scheduled for major abdominal cancer surgeries
- patients with known allergy to the study drugs,
- significant cardiac, respiratory, renal or hepatic disease,
- drug or alcohol abuse,
- psychiatric illness that would interfere with perception and assessment of pain.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Dexmedetomidine group Dexmedetomidine patients received 10 mg of hyperbaric bupivacaine 0.5% in 2 mL volume and 5 μg of dexmedetomidine in 1 mL volume intrathecally. Dexmedetomidine group Bupivacaine patients received 10 mg of hyperbaric bupivacaine 0.5% in 2 mL volume and 5 μg of dexmedetomidine in 1 mL volume intrathecally. Dexmedetomidine + morphine group Bupivacaine patients received 10 mg of hyperbaric bupivacaine 0.5% in 2 mL volume and 5 μg of dexmedetomidine plus 0.5 mg of morphine sulphate in 1 mL volume intrathecally. Morphine group Morphine Sulfate patients received 10 mg of hyperbaric bupivacaine 0.5% in 2 mL volume and 0.5 mg morphine sulphate in 1 mL volume intrathecally. Dexmedetomidine + morphine group Morphine Sulfate patients received 10 mg of hyperbaric bupivacaine 0.5% in 2 mL volume and 5 μg of dexmedetomidine plus 0.5 mg of morphine sulphate in 1 mL volume intrathecally. Morphine group Bupivacaine patients received 10 mg of hyperbaric bupivacaine 0.5% in 2 mL volume and 0.5 mg morphine sulphate in 1 mL volume intrathecally. Dexmedetomidine + morphine group Dexmedetomidine patients received 10 mg of hyperbaric bupivacaine 0.5% in 2 mL volume and 5 μg of dexmedetomidine plus 0.5 mg of morphine sulphate in 1 mL volume intrathecally.
- Primary Outcome Measures
Name Time Method Change from the base line in cellular immunity Baseline , immediate postoperative, 4 hours postoperative and 24 hours postoperative CD3, CD4, CD4/CD8, CD16, CD56
- Secondary Outcome Measures
Name Time Method Change from baseline in Cytokines Baseline, immediate postoperative, 4 hours postoperative and 24 hours postoperative interleukin-1B, interleukin-6, interleukin-10 and tumor necrosis factor
Trial Locations
- Locations (1)
Assiut University
🇪🇬Assiut, Egypt