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

Background: Percutaneous nephrolithotomy (PCNL) is getting very popular for treatment of large renal stones and is considered now to be the first line of treatment. The Erector Spinae block (ESB) is a regional anesthetic technique that is effective in providing extensive somatic and visceral analgesia. Adding dexmedetomidine to the local anesthetic, increases duration of sensory and motor block, and reduces postoperative pain. Objective: Investigating the efficacy of adding dexmedetomidine as an adjuvant to local anesthetic in Erector Spinae Block (ESB) on postoperative pain in patients undergoing Percutaneous nephrolithotomy.Patient and methods: Ultrasound Guided Erector Spinae were done on 50 patients divided equally into two groups 25 each, Groups [A] were received Bupivacaine only and group [B] which received Bupivacaine with the addition of dexmedetomidine). Postoperative 24-hour morphine consumption, intraoperative fentanyl consumption, intraoperative hemodynamics, side effects (Nausea, vomiting, bleeding, and organ injury) were recorded.Results: post-operative morphine consumption(mg/kg) showed statistically significant decrease at Group B than Group A.the median values of morphine consumption were (0.033 versus 0.051) for Group B versus Group A respectively (p+0.001)

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