Lumbar Epidural Analgesia Versus Local Anesthesia With Dexmedetomidine Infusion in Endoscopic Lumbar Discectomy

Ain Shams University

Status: Completed

Conditions: Lumbar Disc Herniation

Treatments: Procedure: Lumbar epidural analgesia with Bupivacaine 0.25% 'Sunnypivacaine'; Drug: Local infiltration with Lidocaine HCL 1%'Debocaine'; Drug: Dexmedetomidine Hydrochloride 'Precedex' combined with; Procedure: General anesthesia

Study type: Interventional

Funder types: Other

Identifiers

NCT05850455

FAMSU R 280/2022/2023

Details and patient eligibility

About

To compare between local anesthesia combined with intravenous Dexmedetomidine and epidural analgesia as regard the effectiveness and patient satisfaction during percutaneous transforaminal endoscopic discectomy.

Full description

Percutaneous transforaminal endoscopic discectomy. under LA is recommended in consideration of safety. Under LA, patients keep conscious during the process of PTED, and the surgeon can obtain feedback directly from the patients if the nerve is interfered. Dexmedetomidine, a highly selective alpha 2 adrenoreceptor agonist, has unique characteristics in providing sedation and analgesia. Due to its central sympatholytic action, Dexmedetomidine produces dose-dependent sedation, antinociception and anxiolysis. Epidural anesthesia is another major method which can keep patients awake during surgery and the surgeons can check the function of the nerve from the maintained motor function of patients' lower limbs

Enrollment: 78 patients

Sex: All

Ages: 18 to 50 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Patients American Society of anesthesiologists' physical status (ASA) I to II.
2. Aged 18 to 50 years.
3. Both sexes.

Exclusion criteria

• Spinal malformation
• Recurrent LDH
• Multi segment LDH
• Patients younger than 18 years or older than 50 years
• Patients with hypersensitivity to one of the used drugs

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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78 participants in 3 patient groups

Group A

Experimental group

Description:

will receive local anesthesia with dexmedetomidine infusion

Treatment:

Drug: Dexmedetomidine Hydrochloride 'Precedex' combined with

Drug: Local infiltration with Lidocaine HCL 1%'Debocaine'

Group B

Experimental group

Description:

will receive epidural analgesia

Treatment:

Procedure: Lumbar epidural analgesia with Bupivacaine 0.25% 'Sunnypivacaine'

Group Con

Experimental group

Description:

will receive general anesthesia

Treatment:

Procedure: General anesthesia