Combining Dexmedetomidine Infusion and Paragastric Autonomic Neural Block to Enhance Postoperative Recovery in Patients Undergoing Laparoscopic Sleeve Gastrectomy

Alexandria University

Status and phase: Enrolling; Phase 2; Phase 1

Conditions: Laparoscopic Sleeve Gastrectomy (LSG)

Treatments: Drug: Dexmedetomidine infusion; Procedure: paragastric autonomic neural block

Study type: Interventional

Funder types: Other

Identifiers

NCT06970678

16/463

Details and patient eligibility

About

The goal of this clinical trial is to learn if combining Dexmedetomidine infusion and paragastric autonomic neural block will enhance the postoperative recovery of patients undergoing laparoscopic sleeve gastrectomy. The main questions it aims to answer are:

Will combining the two techniques (Dexmedetomidine infusion and paragastric autonomic neural block) improve the quality of recovery? Will opioid consumption postoperatively decrease after combining those two techniques? Will the patients be able to start mobilizing sooner after surgery? Will the patient encounter less incidence of nausea and vomiting?

Researchers will asses the quality of the patients' recovery by reviewing the Quality of recovery 40 (QoR 40) questionnaire filled by the patients, assessing hemodynamic parameters intra- and postoperatively, recording the opioids consumed by the patients in the postoperative period, recording the time to first mobilization of the patient, and recording the incidence of nausea and vomiting.

Enrollment: 46 estimated patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. ASA II-III
2. 18-60 years
3. BMI of 35-50 kg/m²

Exclusion criteria

1. Patients with chronic pain disorders
2. Patients using gabapentin, chronic opioid users
3. Patients on anticoagulant therapy
4. Patients with history of upper gastrointestinal system surgery
5. Patients with liver, kidney, cardiovascular diseases
6. Patients with allergy to dexmedetomidine or bupivacaine

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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46 participants in 1 patient group

Patients receiving Dexmedetomidine infusion plus PGANB

Experimental group

Description:

Patients will receive intravenous loading dose of dexmedetomidine at 0.5 μg/kg ideal body weight (concentration 2 μg/ml) over 15 minutes prior to anesthesia induction, followed by 10 ml of 0.9% sodium chloride over 60 seconds during anesthetic induction. Post-intubation, Dexmedetomidine will be maintained at 0.5 μg/kg/h ideal body weight via a syringe pump until trocar removal. Paragastric autonomic neural block (PGANB) will be administered using a 25-gauge needle attached to a venous catheter extension, introduced through the left 12 mm port. Infiltration of 20 mL undiluted 0.5% bupivacaine will be performed at six levels in the fatty tissue of the paragastric area, including the lesser omentum, vagus nerve, esophagogastric junction, proximal stomach, mid-stomach, distal antrum, hepatic artery, and left gastric artery, with the needle cap removed under direct vision throughout the procedure.

Treatment:

Procedure: paragastric autonomic neural block

Drug: Dexmedetomidine infusion