Background:this study compared dexmedetomidine versus dexamethasone as adjuvant to Levobupivacaine 0.25% in ESPB in patients undergoing MRM.
Erector Spinae Plane block (ESPB) is used in patients subjected to modified radical mastectomy (MRM) with various adjuvants. This study compared dexmedetomidine (DEX) versus dexamethasone as adjuvants to ESPB in patients undergoing MRM.
Methods: This randomized controlled study involved 90 patients subjected to MRM under general anesthesia with preoperative ESPB using 30 ml levobupivacaine 0.25%. They were randomly assigned into three equal groups according to the adjuvants used. DEX Group (n=30) received 1 µg/kg dexmedetomidine, Dexamethasone Group (n=30) received 10 mg dexamethasone, and ESPB Group (n=30) received no adjuvants. Patients were monitored for pain using VAS scores and vital signs. The primary outcome measure was total morphine consumption. The secondary outcomes were intraoperative fentanyl consumption, pain intensity, and analgesia duration.
Results:that the post-operative analgesia duration was significantly longer in the DEX group compared with the Plain Levobupivacaine group but not in the Dexamethasone sub group.
Intraoperative fentanyl and postoperative morphine consumption were significantly lower in the DEX group than in the ESPB group. VAS scores were significantly lower in the DEX group than in the ESPB group at rest and movement. VAS scores of the Dexamethasone group were similar to that of the ESPB group at rest and movement.
Conclusion: As an adjuvant to levobupivacaine in ESPB, DEX reduces pain at rest and with movement, reduces intraoperative fentanyl and postoperative morphine consumption, and prolongs the analgesia duration. It is superior to dexamethasone in pain reduction and duration of analgesia.
Key words: Dexamethomideine , erector spinae, post operative analgesia
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