Morphine and Dexmedetomidine as Adjuvants to Bupivacaine in Ultrasound-guided Erector Spinae Plane Block for Open Subcostal Renal Surgeries

Kafrelsheikh University

Status: Completed

Conditions: Open Subcostal Renal Surgeries; Morphine; Adjuvants; Erector Spinae Plane Block; Bupivacaine; Dexmedetomidine; Ultrasound

Treatments: Other: Erector spinae plane block; Drug: Morphine; Drug: Dexmedetomidine

Study type: Interventional

Funder types: Other

Identifiers

NCT07012590

KFSIRB200-525

Details and patient eligibility

About

This study aimed to compare the analgesic efficacy between morphine and dexmedetomidine as adjuvants to bupivacaine in ultrasound-guided erector spinae plane block for open subcostal renal surgeries.

Full description

The postoperative pain that occurs because of the wide flank incision ranges from a moderate to severe intensity and, in some patients, can become chronic.

The erector spinae plane block (ESPB) is a novel interfascial plane technique, aiming to block the dorsal and ventral rami of the spinal nerves to provide visceral and somatic multi-dermatomal analgesia of the cervical, thoracic, and lumbar levels.

Adjuvants to local anesthetics, such as morphine and dexmedetomidine, can be used to improve the quality and duration of peripheral nerve block effects.

Enrollment: 147 patients

Sex: All

Ages: 20 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patient's approval.
• Age: 20 - 65 years.
• Physical Status: American Society of Anesthesiologists (ASA) I & II.
• Patients undergoing open subcostal renal surgeries.

Exclusion criteria

• Patient refusal.
• Age: >65 and <20 years.
• Allergy to Dexmedetomidine, local anesthetics, systemic opioids, and any of the drugs included in the multimodal perioperative pain protocol.
• Patient with coagulation disorders.
• Chronic pain syndromes and patients with chronic opioid use are defined as use of regular daily doses of systemic narcotics for the past 6 months before the surgery.
• Body mass index of 35 kg/ m2 or more.
• Physical Status: American Society of Anesthesiologists (ASA) III & IV.
• Local infection or sepsis at the site of injection.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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147 participants in 3 patient groups

Morphine group

Experimental group

Description:

Patients received erector spinae plane block with morphine 2 mg as an adjuvant to bupivacaine 30 ml 0.25%.

Treatment:

Drug: Morphine

Dexmedetomidine group

Experimental group

Description:

Patients received erector spinae plane block with dexmedetomidine 100 µg as an adjuvant to bupivacaine 30 ml 0.25%.

Treatment:

Drug: Dexmedetomidine

Control group

Active Comparator group

Description:

Patients received erector spinae plane block with bupivacaine 30 ml 0.25% only.

Treatment:

Other: Erector spinae plane block