The role of dexmedetomidine as an adjuvant for high-thoracic erector spinae plane block for analgesia in shoulder arthroscopy; a randomized controlled study
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 e...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-023-02014-2 |
| _version_ | 1827982986296950784 |
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| author | Mohamed Ahmed Hamed Omar Sayed Fargaly Rana Ahmed Abdelghaffar Mohammed Ahmed Moussa Mohammad Fouad Algyar |
| author_facet | Mohamed Ahmed Hamed Omar Sayed Fargaly Rana Ahmed Abdelghaffar Mohammed Ahmed Moussa Mohammad Fouad Algyar |
| author_sort | Mohamed Ahmed Hamed |
| collection | DOAJ |
| description | 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 1st 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 1st 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). |
| first_indexed | 2024-04-09T22:40:40Z |
| format | Article |
| id | doaj.art-976ced2e02644561b92e37c1180cc72b |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-04-09T22:40:40Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-976ced2e02644561b92e37c1180cc72b2023-03-22T12:12:33ZengBMCBMC Anesthesiology1471-22532023-02-012311710.1186/s12871-023-02014-2The role of dexmedetomidine as an adjuvant for high-thoracic erector spinae plane block for analgesia in shoulder arthroscopy; a randomized controlled studyMohamed Ahmed Hamed0Omar Sayed Fargaly1Rana Ahmed Abdelghaffar2Mohammed Ahmed Moussa3Mohammad Fouad Algyar4Department of Anesthesiology, Faculty of Medicine, Fayoum UniversityDepartment of Anesthesiology, Faculty of Medicine, Fayoum UniversityDepartment of Anesthesiology, Faculty of Medicine, Fayoum UniversityDepartment of Orthopedics, Faculty of Medicine, Fayoum UniversityDepartment of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Kafrelsheikh UniversityAbstract 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 1st 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 1st 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).https://doi.org/10.1186/s12871-023-02014-2DexmedetomidineErector spinae plane blockShoulder arthroscopy |
| spellingShingle | Mohamed Ahmed Hamed Omar Sayed Fargaly Rana Ahmed Abdelghaffar Mohammed Ahmed Moussa Mohammad Fouad Algyar The role of dexmedetomidine as an adjuvant for high-thoracic erector spinae plane block for analgesia in shoulder arthroscopy; a randomized controlled study BMC Anesthesiology Dexmedetomidine Erector spinae plane block Shoulder arthroscopy |
| title | The role of dexmedetomidine as an adjuvant for high-thoracic erector spinae plane block for analgesia in shoulder arthroscopy; a randomized controlled study |
| title_full | The role of dexmedetomidine as an adjuvant for high-thoracic erector spinae plane block for analgesia in shoulder arthroscopy; a randomized controlled study |
| title_fullStr | The role of dexmedetomidine as an adjuvant for high-thoracic erector spinae plane block for analgesia in shoulder arthroscopy; a randomized controlled study |
| title_full_unstemmed | The role of dexmedetomidine as an adjuvant for high-thoracic erector spinae plane block for analgesia in shoulder arthroscopy; a randomized controlled study |
| title_short | The role of dexmedetomidine as an adjuvant for high-thoracic erector spinae plane block for analgesia in shoulder arthroscopy; a randomized controlled study |
| title_sort | role of dexmedetomidine as an adjuvant for high thoracic erector spinae plane block for analgesia in shoulder arthroscopy a randomized controlled study |
| topic | Dexmedetomidine Erector spinae plane block Shoulder arthroscopy |
| url | https://doi.org/10.1186/s12871-023-02014-2 |
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