Key result
Adding dexmedetomidine to bupivacaine in ultrasound-guided erector spinae block significantly reduced intraoperative fentanyl consumption during spine surgery (p<0.003).
Why the study?
Does the addition of dexmedetomidine to bupivacaine in ultrasound-guided erector spinae block improve postoperative analgesia and reduce opioid consumption in patients undergoing spine surgery?
RCT (n=70)
Randomized
No
Does the addition of dexmedetomidine to bupivacaine in ultrasound-guided erector spinae block improve postoperative analgesia and reduce opioid consumption in patients undergoing spine surgery?
p-value: p=<0.003
The addition of dexmedetomidine to bupivacaine in ultrasound-guided erector spinae block during spine surgery reduces intraoperative and postoperative opioid consumption and prolongs the time to first postoperative analgesic dose.
Supports dexmedetomidine addition to bupivacaine ESPB for lower pain scores and opioid use after lumbosacral spine fixation; extends RCT evidence for this adjunct.
Background: During spine surgery, mechanical and thermal trauma can cause muscle ischemia and damage to nerves innervating the paraspinal muscles. Therefore, it is often characterized by severe and diffuse pain in the postoperative period, so adequate postoperative analgesia is essential to allow early mobilization, reducing the incidence of postoper-ative respiratory complications, and decrease the risk of chronic pain syndrome. Aim of Study: To investigate the effectiveness of a mixture of dexmedetomidine and bupivacaine versus bupivacaine alone for ESB for postoperative analgesia in spine surgery. Patients and Methods: The study was conducted at Neu-rosurgery operation Theater at Souad Kafafi University Hos-pital-Misr University of science and Technology (MUST). 70 Patients aged above 21 years, scheduled for spine surgery, 35 patients in each group equally. Results: Intra operative Fentanyl Consumption (µg/kg) there was significantly lower in Bupivacaine & Dexmedeto-midine group (p<0.003). Postoperative pain (VAS-10) among both study groups there weren't significantly lower in Bupi-vacaine & Dexmedetomidine group throughout follow-up time points, but the differences were statistically significant at hour 8, 12 and 24. Post-operative morphine consumption there was significantly lower in Bupivacaine& Dexmedeto-midine group. Time to first postoperative dose was significantly longer in Bupivacaine & Dexmedetomidine group. Post-operative complications related to morphine consumption (nausea, vomiting and pruritus) were less frequent in Bupi-vacaine& Dexmedetomidine group, but the differences were statistically significant only in nausea. Conclusion: The addition of dexmedetomidine to bupi-vacaine in US-guided Erector Spinae block during spine surgery reduce both intra operative fentanyl consumption and post operative morphine consumption, significantly prolong time to first postoperative morphine dose and reduces post-operative Nausea, vomiting (PONV) and pruritis owing to lowering the total opioid consumption compared with bupi- vacaine alone.
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M.Sc. MANAR M. ELKHOLY ASMAA A. YOUSSEF MOHAMED (2023) conducted an RCT in Spine surgery (n=70). Dexmedetomidine added to bupivacaine vs. Bupivacaine alone was evaluated on Intra operative Fentanyl Consumption (µg/kg) (p=<0.003). Adding dexmedetomidine to bupivacaine in ultrasound-guided erector spinae block significantly reduced intraoperative fentanyl consumption during spine surgery (p<0.003).
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