Efficacy of adding dexmedetomidine as adjuvant with bupivacaine in ultrasound-guided erector spinae plane block for post thoracotomy pain : Randomized controlled study / Aya Mohamed Ahmed Baiomy Ahmed ; Supervised Nevine Mahmoud Gouda , Mohamed Mohammed Abdelhak , Mamdouh Mahmoud Mostafa Elshal

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Anesthesia

Background:Pain has a wide spectrum of effects on the body and poor management of postoperative pain results in multiple physiologic and psychological side effects; and increases morbidity. The use of opioid-based analgesia in high doses can have multiple side effects including nausea, vomiting, and respiratory depression. Objectives:Our aim was to assess the analgesic outcome of adding dexmedetomidine as adjuvant with bupivacaine in ultrasound guided Erector Spinae Plane Block as perioperative analgesia for thoracic cancer surgeries. Patients and Methods:42 patients ASA I - II scheduled for thoracotomy for cancer surgeries under GA were recruited .Patients were allocated into 2 groups: group 1 (ESPB without dexmedetomidine) N=21 and group 2 (ESPB with dexmedetomidine) N=21.The total amount of morphine consumption in the first 24 hours postoperatively, Total amount of intraoperative fentanyl and block related complications were recorded,Visual analogue score (VAS) score, both at rest and during movement, Nausea and vomiting Scores,Ramsay Sedation score at 0,2,4,6,12,18,24 hours and overall patient satisfaction were recorded. Results:ESPBwith Dexmedetomidinegrouppatients consumed less total postoperative morphine and intraoperative fentanyl (1.71±1.79mg, 153.33±23.09og respectively) than the ESPB without Dexmedetomidine group patients (4.40±1.55mg,169.05±31.88og respectively).In addition,ESPB with Dexmedetomidine group showed statistically significant lower score of visual analog scale at rest and at movement

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