Effect of Adding Dexmedetomidine to Bupivacaine in Ultrasound Guided Rectus Sheath Block: A Randomized Controlled Double-blinded Study
Wafaa T Salem1, Khaled A Alsamahy1, Wael A Ibrahim1, Abear S Alsaed2, Mohamed M Salaheldin1, *
1 Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt
2 Department of Clinical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt
Abstract
Background:
Extended midline laparotomy incision is accompanied by intense pain postoperatively which affects patients’ physiology; therefore, good control of postoperative pain is mandatory to decrease the adverse effects on the body. Ultrasound-guided Bilateral Rectus Sheath Block (BRSB) is one of the options to achieve this goal.
Objective:
The study aimed to assess the analgesic potency of adding dexmedetomidine to bupivacaine in ultrasound-guided BRSB in cancer patients with a midline laparotomy incision.
Methods:
Sixty adult cancer patients planned for laparotomies with extended midline incision were included. Ultrasound-guided BRSB was performed immediately after the induction of anesthesia.
Patients were classified randomly into two groups; B group, where only bupivacaine was used for BRSB and BD group in whom a mixture of bupivacaine and dexmedetomidine was used.
Results:
A significant decrease in visual analogue scale scores, total morphine consumption, postoperative nausea and vomiting and postoperative cortisol levels was observed in group BD.
Conclusion:
Dexmedetomidine as an adjuvant to bupivacaine in US-guided rectus sheath block bilaterally proved to be effective for proper pain management postoperatively in cancer patients after extended midline abdominal incision.
Keywords: Rectus sheath block, Dexmedetomidine, Pain, Regional anesthesia, Midline abdominal incision, Abdominal cancers.
Article Information
Article History:
Received Date: 31/01/2019
Revision Received Date: 21/03/2019
Acceptance Date: 2/04/2019
Electronic publication date: 30/04/2019
Collection year: 2019
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© 2019 Salem et al.
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (
https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
* Address correspondence to this author at Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Egypt Fom EL Khaleeg, Cairo, Egypt; Tel: +20237604220; Email: mail@mcs-center.com
Open Peer Review Details |
Manuscript submitted on 31-01-2019 |
Original Manuscript |
Effect of Adding Dexmedetomidine to Bupivacaine in Ultrasound Guided Rectus Sheath Block: A Randomized Controlled Double-blinded Study |