Erector Spinae Block Using a Dexmedetomidine Versus Magnesium Sulfate as an Adjuvant to Bupivacaine
Condition: Postoperative Analgesia
Study type: Interventional

Summary: 
      This prospective parallel group randomized study will be conducted over 52 adult participants
      between 20 and 60 years ASA (American Association of Anesthesiologists) I and II undergoing
      lumbar spine surgery. The participants will be randomly allocated into 2 groups. Group BM
      (Bupivacaine + magnesium sulfate) will receive bilateral erector spinae block using
      bupivacaine and magnesium sulfate after induction of general anesthesia, while group BD
      (Bupivacaine + dexmedetomidine) will receive bilateral erector spinae block using bupivacaine
      and dexmedetomidine after induction of general anesthesia. Hemodynamic changes will be
      monitored intraoperatively, and postoperative pain will be assessed using the visual analogue
      scale in order to assess the need for postoperative analgesia.
    

Detailed description: 
      This prospective parallel group randomized study will be conducted over 52 adult participants
      between 20 and 60 years ASA (American Association of Anesthesiologists) I and II undergoing
      lumbar spine surgery. The participants will be randomly allocated into 2 groups.

      General anesthesia will be induced using propofol 1-2mg/kg, fentanyl 2ug/kg, and atracurium
      0.5mg/kg.

      Both groups will receive bilateral erector spinae block Group BM will receive bilateral
      erector spinae block .A technique that will be performed ultrasound guided to identify the
      transverse process of T10, and an 18G (gauge) needle will be introduced in plane deep to the
      erector spinae muscle after which a combination of 20ml bupivacaine 0.25% and 2.5 ml
      magnesium sulfate.

      While group BD will receive the same block with the with 20ml bupivacaine 0.25% and
      dexmedetomidine 1ug/kg.

      Hemodynamic changes will be monitored intraoperatively, for detection of any variations.

      Postoperative pain will be assessed every 2 hours following the surgery using the visual
      analog scale in order to assess the need for postoperative analgesia.

      Analgesia will be given in the form of nalbuphine 10mg when the visual analog scale is above
      4.

      Patient satisfaction will be measured by a scale from 1-10 the next day. Any complications
      will be recorded.
    

Intervention name(s): Erector spinae block using bupivacaine 0.25% and magnesium sulfate; Erector spinae block using bupivacaine and dememdetomidine
Intervention type(s): Procedure; Procedure
Intervention description(s): After induction of general anesthesia the patients will be flipped to the prone position and ESP block was performed using, a high frequency linear ultrasound probe placed longitudinally 2 to 3 cm lateral to the 10th thoracic vertebrae, and the trapezius and erector Spinae muscles identified.
An 18-G Tuohy needle passed along the plane of the transducer until its tip hit the transverse process of T10; the needle was then withdrawn slightly.
Total volume of 25 ml was injected including 20 mL 0.25% bupivacaine plus 3.75 ml NS and 125 mg MgSO4 (1.25ml).; After induction of general anesthesia the patients will be flipped to the prone position and ESP block was performed using, a high frequency linear ultrasound probe placed longitudinally 2 to 3 cm lateral to the 10th thoracic vertebrae, and the trapezius and erector Spinae muscles identified.
An 18-G Tuohy needle passed along the plane of the transducer until its tip hit the transverse process of T10; the needle was then withdrawn slightly.
Total volume of 25 ml was injected including 20 mL 0.25% bupivacaine plus dexmedetomidine 1ug/kg.
Intervention MeSH terms: Magnesium Sulfate; Bupivacaine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment