Comparing the Analgesic Effects of Different Doses of Dexmedetomidine as an Adjuvant in External Oblique Intercostal Plane Block in Splenectomy: A Randomized Trial
Overview
- Phase
- Not Applicable
- Intervention
- Dexmedetomidine 0.5 μg/kg
- Conditions
- Dexmedetomidine
- Sponsor
- Tanta University
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- Time to the 1st rescue analgesia
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
The aim of this study is to compare the analgesic effects of different doses of dexmedetomidine as an adjuvant in external oblique intercostal plane block (EOIPB) in splenectomy.
Detailed Description
External oblique intercostal plane block (EOIPB) was reported by Elsharkawy et al . It is a novel block, which has been described as an important modification of the fascial plane blocks that can consistently involve the upper lateral abdominal walls. In comparison to quadratus lumborum block (QLB) and erector spinae plane block (ESPB) , EOIPB has the benefit of being performed when the patient is supine. It also has an advantage over serratus intercostal plane block (SIPB) in that it produces greater analgesia throughout the midline of the abdomen. Dexmedetomidine is used for sedation in patients admitted to the intensive care unit (ICU). Dexmedetomidine is a selective alpha 2- adrenoceptor agonist possessing sedative, anxiolytic, and analgesic properties without the development of respiratory depression . Several studies have shown that dexmedetomidine has an anesthetic sparing effect, which has led to its use as a general adjuvant for prolonging peripheral nerve block duration.
Investigators
Mohammed Said ElSharkawy
Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Tanta University
Eligibility Criteria
Inclusion Criteria
- •Age ≥ 18 years.
- •Both sexes.
- •American Society of Anesthesiology (ASA) physical status II-III.
- •Scheduled for splenectomy.
Exclusion Criteria
- •Body mass index (BMI) ≥35 kg/m2
- •History of abdominal surgery.
- •Infection at the injection site.
- •Drug abuse.
- •Allergic reaction to local anesthetics.
- •Coagulation abnormalities.
- •Pregnancy.
- •Severe cardiovascular problems.
- •Diabetic neuropathy.
Arms & Interventions
Group dexmedetomidine 0.5
Patients will receive 29 ml bupivacaine 0.25% + 1 ml dexmedetomidine 0.5 μg/kg diluted in saline.
Intervention: Dexmedetomidine 0.5 μg/kg
Group dexmedetomidine1
Patients will receive 29 ml bupivacaine 0.25% + 1 ml dexmedetomidine 1 μg/kg diluted in saline.
Intervention: Dexmedetomidine 1 μg/kg
Outcomes
Primary Outcomes
Time to the 1st rescue analgesia
Time Frame: 48 hour Postoperatively
Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the NRS \< 4. NRS will be assessed at 0, 4, 8, 12, 18, 24, 36 and 48 h postoperatively. Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable").
Secondary Outcomes
- Heart rate(Till the end of surgery)
- Intraoperative fentanyl consumption(Intraoperatively)
- Mean arterial pressure(Till the end of surgery)
- Total morphine consumption(48 hour postoperatively)
- Degree of pain(48 hours postoperatively)
- The incidence of adverse events(48 hour postoperatively)