Efficacy of adding dexmedetomidine as adjuvant with levobupivacaine in ultrasound-guided serratus plane block for modified radical mastectomy surgery

Gad, Mona; Elmetwally, Mohamed

doi:10.4103/roaic.roaic_23_19

Cited by 6 publications

(7 citation statements)

References 1 publication

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“…Studies [17][18][19] have shown no significant increase with the use of dexmedetomidine. Other studies [14,20] have observed significant bradycardia and hypotension after dexmedetomidine use, which we did not notice in our trial. Considering the low incidence of systemic adverse effects associated with perineural dexmedetomidine, our study did not find any significant difference in the incidence of side effects between the groups.…”

Section: Discussioncontrasting

confidence: 78%

“…Also, Gad and El-Metwally [14] evaluated the effectiveness of adding dexmedetomidine to levobupivacaine in a US-guided serratus plane block for modified radical mastectomy. In accordance with their results, adding dexmedetomidine to levobupivacaine significantly decreased VAS at 8 and 12 hours postoperatively and total postoperative pethidine consumption.…”

Section: Discussionmentioning

confidence: 99%

“…Blocks were performed with a US machine (Sonosite Edge; Sonosite Inc., USA) equipped with an HFL38X high-frequency linear transducer (13)(14)(15)(16). With patients in sitting position, the transducer was positioned longitudinally 3 cm lateral to the T5 spinous process.…”

Section: The Us Guided Espbmentioning

confidence: 99%

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Efficacy of adding dexmedetomidine as adjuvant with bupivacaine in ultrasound-guided erector spinae plane block for post thoracotomy pain: Randomized controlled study

Elshal

Gamal

Ahmed

et al. 2021

Egyptian Journal of Anaesthesia

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Background: Poor management of postoperative pain results in physiological and psychological side effects with higher morbidity. Erector spinae plane block (ESPB) has shown efficacy in controlling pain in many surgeries. Dexmedetomidine has improved the quality of analgesia in many regional techniques. This study aimed to assess the analgesic outcome of adding dexmedetomidine to bupivacaine in ultrasound (US) guided ESPB for perioperative analgesia for thoracic cancer surgeries. Patients and Methods: In this randomized controlled, double-blind study, 42 patients aged 18-65 years, ASA (American Society of Anesthesiologists) physical status II, scheduled for thoracotomy for cancer surgeries under general anesthesia were included. Patients were allocated into two equal groups: group 1 (ESPB by 28 ml bupivacaine 0.25% + 2 mL saline) and group 2 (ESPB 28 ml bupivacaine 0.25% + 2 mL dexmedetomidine 0.5 µg/kg). Blocks were performed before anesthesia induction. Results: Group 2 consumed lower intraoperative fentanyl and postoperative morphine and had a lower pain score at rest and cough compared to group 1. Group 2 had prolonged time to first request of rescue analgesia compared to group 1. Postoperative nausea and vomiting, and sedation were comparable between both groups. No block-related complications were observed. Conclusions: Adding dexmedetomidine to bupivacaine in US-guided ESPB provided more effective and safe analgesia in thoracotomy.

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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Efficacy of adding dexmedetomidine as adjuvant with bupivacaine in ultrasound-guided erector spinae plane block for post thoracotomy pain: Randomized controlled study

Elshal

Gamal

Ahmed

et al. 2021

Egyptian Journal of Anaesthesia

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“…20 It has also been found that the addition of dexmedetomidine 0.5 µg/kg as an adjuvant to levobupivacaine of 0.25% in US-guided serratus plain block during modified radical mastectomy surgery can give extended analgesic effect and lower postoperative opioid consumption. 21 Also adding dexmedetomidine 0.5 µg/kg to bupivacaine 28 mL…”

Section: Discussionmentioning

confidence: 99%

Comparing Effect of Adding Ketamine Versus Dexmedetomidine to Bupivacaine in Pecs-ⅠⅠ Block on Postoperative Pain Control in Patients Undergoing Breast Surgery

Hefni

Eldeek

Ismael

et al. 2022

The Clinical Journal of Pain

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Background: Pectoralis and serratus plane blocks (Pecs-II block) has successfully demonstrated a good quality of perioperative analgesia for breast surgery.Objective: This study aimed to compare the quality of postoperative pain control when adding either ketamine or dexmedetomidine to bupivacaine 0.25% for Pecs-II block.Methods: This prospective randomized double-blind study was conducted on 159 female patients with American Society of Anesthesiologist (ASA) physical status class I-III scheduled to have modified radical mastectomy. Patients were randomly assigned into 3 groups. Each group included 53 patients to receive ultrasound guided Pecs-II blocks with either 32 mL of 0.25% bupivacaine added to ketamine hydrochloride 1 mg/kg (BK group), 32 mL of 0.25% bupivacaine added to dexmedetomidine 1 ug/kg (BD group) or 32 mL of 0.25% bupivacaine only (B group). The primary outcome was the total postoperative morphine consumption for the first 24 hours postoperatively. The time of the first request of analgesia, the pain scores at rest of ipsilateral arm, and the intraoperative fentanyl requirements, were the secondary outcome measures. Any side effects occurred were recorded.Results: The total postoperative morphine consumption was significantly lower in patients received bupivacaine with addition of either ketamine (BK group), (10.3 ± 2.6 mg), or dexmedetomidine (BD group), (3.8 ± 0.2 mg) respectively, versus patients received only bupivacaine (B group), (16.9 ± 5.3 mg). Both ketamine (BK group) and dexmedetomidine (BD group) added to bupivacaine significantly prolonged the time to first analgesic request (16.7 ± 4.5 h), (21.6 ± 1.6 h) in both groups respectively compared with patients received bupivacaine alone (B group) (11.5 ± 1.2 h). The pain score was variable between the 3 groups during the first 24 hours postoperatively. There were no statistically significant differences in perioperative hemodynamics, O 2 saturation, sedation scores, or side effects observed between the 3 groups. Patient satisfaction was reported to be the best in patients received dexmedetomidine added to bupivacaine compared to the patients who received ketamine as an additive or those who received bupivacaine alone. Conclusion:Adding dexmedetomidine to bupivacaine provides more effective postoperative pain control than adding ketamine during Pecs-II blocks for breast cancer surgery.

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“…Dexmedetomidine can prolong the duration of the nerve block when used with local anesthetic (6) . It produces analgesia by different mechanism of action (8) . This double-blind randomized control study was designed to compare the ESPB characteristics and side effects following erector spinae plane block with bupivacaine versus erector spinae plane block with bupivacaine supplemented with either dexamethasone or dexmedetomidine in patients scheduled for total abdominal hysterectomy.…”

Section: Introductionmentioning

confidence: 99%

Dexamethasone versus Dexmedetomidine as Adjuvant to Bupivacaine in Ultrasound Guided Erector Spinae Plane Block for Analgesia in Total Abdominal Hysterectomy

Ali¹,

Salama²,

Abaza³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Local anesthetic adjuvants prolong analgesia duration with single shot interfascial plane blocks. They potentiate the analgesic effect of the local anesthetics. These adjuvants include several groups and different mechanisms of action such as dexamethasone and dexmedetomidine. Objectives: This study was aimed at achievement of better analgesia for total abdominal hysterectomy patients via prolongation of sensory block duration and reducing opioid consumption. Patients and Methods: This study was carried out at Zagazig University Hospitals where 84 female patients scheduled for total abdominal hysterectomy aged from 40 to 60 years, ASA physical status grade I, II and body mass index (BMI) 18.5-30 kg/m 2 . Patients were classified into three groups (28 each), group C (received bilateral ESPB with 20 ml bupivacaine 0.25% plus 1ml saline), group O (received bilateral ESPB with 20 ml bupivacaine 0.25% plus 1ml dexamethasone (4mg)), group D (received bilateral ESPB with 20 ml bupivacaine 0.25% plus 1 ml dexmedetomidine (0.5ug/kg) in saline). They underwent history taking, general examination, laboratory investigations, preoperative erector spinae plane block (ESPB) and GA. Results: There was statistically significant difference between three groups regarding visual analog scale (VAS) and nalbuphine consumption where D group had better pain control than other groups. Conclusions: It could be concluded that dexmedetomidine as an adjuvant to 0.25% bupivacaine in ultrasound guided erector spinae plane block is more efficacious than dexamethasone in hastening the onset, prolonging sensory blockade, delaying the time for request of rescue analgesia, and decreasing total nalbuphine consumption.

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Efficacy of adding dexmedetomidine as adjuvant with levobupivacaine in ultrasound-guided serratus plane block for modified radical mastectomy surgery

Cited by 6 publications

References 1 publication

Efficacy of adding dexmedetomidine as adjuvant with bupivacaine in ultrasound-guided erector spinae plane block for post thoracotomy pain: Randomized controlled study

Efficacy of adding dexmedetomidine as adjuvant with bupivacaine in ultrasound-guided erector spinae plane block for post thoracotomy pain: Randomized controlled study

Comparing Effect of Adding Ketamine Versus Dexmedetomidine to Bupivacaine in Pecs-ⅠⅠ Block on Postoperative Pain Control in Patients Undergoing Breast Surgery

Dexamethasone versus Dexmedetomidine as Adjuvant to Bupivacaine in Ultrasound Guided Erector Spinae Plane Block for Analgesia in Total Abdominal Hysterectomy

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