Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Anesthesia

Objectives:In this study we compared the benefits of adding the new Ü2 adrenergic blocker dexmedetomidine to levobupivacaine in SNB for patients undergoing craniotomy for supratentorial tumors as regarding effect on hemodynamics intra and post operative , duration of postoperative analgesia and effect on plasma cortisol level .Patients & Methods:Sixty patients were enrolled in the study randomly divided in 2 equal groups , one received SNB with levobupivacaine L, and the other group received SNB with levobupivacaine plus dexmedetomidine LD .There were 40 male and 20 female patients with a mean age of 44.4±10 in group L and 41.3±9.3 in group LD, ASA I & II Hemodynamic (mean arterial blood pressure and heart rate) was recorded at baseline, 5 minutes after skin incision, 5 minutes after dural incision, 5 minutes after dural closure, 5 minutes after extubation. Cortisol level was measured before induction as baseline in the morning, 1 hour after skin incision, 24 hour after extubation) After extubation postoperative pain assessment was done using visual analogue scale. pain score. At least 5 on VAS is accepted if it is above this, paracetamol 1 gm and ketolac 30 mg iv will be given to patient. Only data will be obtained from patients who are oriented to person, place, and time and with a Glasgow coma score of at least 14. Results: Patients in group LD had significantly lower HR and MAP and longer duration in postoperative analgesia than group L. There is no significant difference in plasma cortisol level between the two groups

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