Effect of Dexmedetomidine Versus Dexamethasone as Adjuvant to Bupivacaine in Ultrasound Guided Erector Spinae Plane Block on Postoperative Analgesia in Myasthenic Patients Undergoing Thoracoscopic Thymectomy

Обзор

This current comparative study involved 54 patients undergoing thoracoscopic thymectomy who were distributed randomly into three equal groups to receive ultrasound (US)-guided ESPB using 20 ml bupivacaine 0.25% (group B) , 20 ml bupivacaine 0.25% with 8 mg dexamethasone (group BS), 20 ml bupivacaine 0.25% with dexmedetomidine 1mcg/kg (group BM). The time till the first postoperative rescue analgesic requested was the primary outcome. The secondary outcomes included the postoperative pain scores and analgesic consumption.

Вмешательства

• Процедура Erector Spinae Plane Block
  An echogenic 21 gauge 10 cm needle was introduced in caudo-cephalic orientation utilizing the in-plane approach and traversing through trapezius, rhomboid, and erector spinae muscles till reaching the transverse process then slightly withdrawn and hydrodissection was done by 3 mL of saline 0.9% to verify the accurate implantation of the block needle tip between the erector spinae muscle and the transverse process (the erector spinae plane). Incremental LA injection was verified through US observ
• Процедура Erector Spinae Plane Block
  An echogenic 21 gauge 10 cm needle was introduced in caudo-cephalic orientation utilizing the in-plane approach and traversing through trapezius, rhomboid, and erector spinae muscles till reaching the transverse process then slightly withdrawn and hydrodissection was done by 3 mL of saline 0.9% to verify the accurate implantation of the block needle tip between the erector spinae muscle and the transverse process (the erector spinae plane). Incremental LA injection was verified through US observ
• Процедура Erector Spinae Plane Block
  An echogenic 21 gauge 10 cm needle was introduced in caudo-cephalic orientation utilizing the in-plane approach and traversing through trapezius, rhomboid, and erector spinae muscles till reaching the transverse process then slightly withdrawn and hydrodissection was done by 3 mL of saline 0.9% to verify the accurate implantation of the block needle tip between the erector spinae muscle and the transverse process (the erector spinae plane). Incremental LA injection was verified through US observ

Первичные конечные точки

• the duration between the surgery end and the 1st rescue analgesia the patient requested. [Срок оценки: 24 hours postoperatively]

Вторичные конечные точки (2)

• .Total ketorolac consumption [Срок оценки: 24 hours postoperatively]
• . Number of patients needed rescue tramadol [Срок оценки: 24 hours postoperatively]

Критерии участия

Критерии включения

• myasthenic patients
• American Society of Anesthesiologists (ASA) physical grade of 2-3)
• who underwent video assisted thoracoscopic thymectomy

Критерии исключения

• Refused participation in the study,
• known allergy for this study drugs ,
• Contraindication to the ESPB as infection at block site \& marked chest cage deformity,
• significant bleeding disorders ,
• patients with significant renal or liver dysfunction,
• heart block ,
• poor ventilatory function,
• severe chronic obstructive pulmonary disease,
• morbid obesity,
• mental disability, or communication difficulties that hindered effective pain assessment,
• Individuals who was converted to open thoracotomy or those re-explorated for surgical related issues.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Четверное слепое

Основная цель

Профилактика

Центры проведения

Список центров уточняется — проверьте первичный протокол.

Идентификаторы

NCT: NCT07424599 · HRM 3

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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