医学
右美托咪定
麻醉
布比卡因
芬太尼
吗啡
止痛药
随机对照试验
麻醉学
佐剂
局部麻醉剂
外科
内科学
镇静
作者
Mohamed Ahmed Hamed,Omar Sayed Fargaly,Rana Ahmed Abdelghaffar,Mohammed Ahmed Moussa,Mohammad Fouad Algyar
标识
DOI:10.1186/s12871-023-02014-2
摘要
Abstract Background Management of postoperative pain after shoulder arthroscopy is an important issue. Dexmedetomidine, as an adjuvant, improves nerve block efficacy and decreases postoperative consumption of opioids. As a result, we designed this study to determine if adding dexmedetomidine to an erector spinae plane block (ESPB) that is guided by ultrasound (US) is beneficial for treating immediate postoperative pain following shoulder arthroscopy. Methods This randomized controlled double-blind trial recruited 60 cases 18–65 years old of both sexes, American Society of Anesthesiologists (ASA) physical status I-II, scheduled for elective shoulder arthroscopy. Random allocation of 60 cases was done equally into two groups according to the solution injected in US-guided ESPB at T2 before general anesthetic induction. Group (ESPB): 20 ml 0.25% bupivacaine. Group (ESPB + DEX): 19 ml bupivacaine 0.25% + 1 mL dexmedetomidine 0.5 µg/kg. The primary outcome was The total rescue morphine consumption in the first 24 postoperative hours. Results The mean intraoperative fentanyl consumption was significantly lower in the group (ESPB + DEX) compared to the group (ESPB) (82.86 ± 13.57 versus 100.74 ± 35.07, respectively, P = 0.015). The median (IQR) time of the 1 st rescue analgesic request was significantly delayed in the group (ESPB + DEX) compared to group (ESPB) [18.5 (18.25–18.75) versus 12 (12–15.75), P = 0.044]. The number of cases that required morphine was significantly lower in the group (ESPB + DEX) than in the group (ESPB) ( P = 0.012). The median (IQR) of total postoperative morphine consumption in 1 st 24 h was significantly lower in the group (ESPB + DEX) compared to the group (ESPB) [0 (0–0) versus 0 (0–3), P = 0.021]. Conclusion The dexmedetomidine as an adjuvant to bupivacaine in ESPB produced adequate analgesia by reducing the intraoperative and postoperative opioid requirements in shoulder arthroscopy. Trial Registration This study is registered on ClinicalTrials.gov (NCT05165836; principal investigator: Mohammad Fouad Algyar; registration date: 21/12/ 2021).
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