Analgesic Efficacy of Adding Dexmedetomidine to Erector Spinae Plane Block Versus Subcostal Transverse Abdominis Plane Block in Laparoscopic Cholecystectomy

Kafrelsheikh University

Status: Completed

Conditions: Subcostal Transverse Abdominis Plane Block; Erector Spinae Plane Block; Laparoscopic Cholecystectomy; Dexmedetomidine; Analgesic Efficacy

Treatments: Other: Erector spinae plane block; Other: Subcostal transverse abdominis plane block

Study type: Interventional

Funder types: Other

Identifiers

NCT07075913

KFSIRB200-624

Details and patient eligibility

About

Our scientific work aimed to evaluate the analgesic efficacy of dexmedetomidine as an adjuvant to erector spinae plane block versus subcostal transverse abdominis plane block in patients undergoing laparoscopic cholecystectomy.

Full description

Laparoscopic cholecystectomy (LC) is the most commonly performed surgical procedure for the management of cholelithiasis. Acute pain after LC consists of somatic, parietal, and referred pain caused by trocar insertion, gall bladder resection, carbon dioxide insufflation, and other factors.

The subcostal transverse abdominis plane (SCTAP) block is the deposition of local anesthetic in the transverse abdominis plane inferior and parallel to the costal margin.

Ultrasound-guided erector spinae plane block (ESPB) is a popular, interfascial regional technique initially described for managing thoracic neuropathic pain.

Dexmedetomidine is an alpha-2 adrenergic receptor agonist that has been the focus of interest due to its sedative, analgesic, perioperative sympatholytic, and cardiovascular-stabilizing effects, resulting in reduced anesthetic requirements.

Enrollment: 40 patients

Sex: All

Ages: 20 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age from 20 to 60 years.
• Both sexes.
• American Society of Anesthesiologists (ASA) physical status I and II.
• Patients were planned to undergo laparoscopic cholecystectomy.

Exclusion criteria

• Patient's refusal to participate in the study.
• ASA III, IV.
• History of clinically significant cardiac, hepatic, renal, respiratory or neurological disease.
• Coagulopathy and bleeding disorders.
• Known allergy to any drug included in the study.
• Systemic or local infection at the puncture site.
• Body mass index (BMI) >35 (kg/m2).
• Failed technique.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

40 participants in 2 patient groups

Group I

Experimental group

Description:

Patients received an ultrasound-guided subcostal transverse abdominis plane block with injection of 10 ml bupivacaine 0.25 %, 5ml lignocaine 2 % plus 0.5 μg/kg dexmedetomidine in a 20 ml volume.

Treatment:

Other: Subcostal transverse abdominis plane block

Group II

Experimental group

Description:

Patients will receive an ultrasound-guided erector spinae plane block (ESPB) with injection of 10 ml bupivacaine 0.25%, 5 ml lignocaine 2 % plus 0.5 μg/kg dexmedetomidine in a 20 ml volume.

Treatment:

Other: Erector spinae plane block