Dexmedetomidine vs Dexamethasone as Adjuvant to Bupivacaine in Bilevel Erector Spinae Plane Block in Breast Surgeries

Study Overview
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Brief Summary
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High percent of patients experience chronic pain following breast cancer surgeries thus proper perioperative pain control is crucial to lessen the incidence of such pain. Several techniques are adopted to control perioperative pain, these techniques include drugs as opioids and adjuvants as well as regional blocks. Erector spinae plane block is a regional technique that is used efficiently to control perioperative pain during and following breast cancer surgeries.

Detailed Description
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High percent of patients experience chronic pain following breast cancer surgeries thus proper perioperative pain control is crucial to lessen the incidence of such pain. Several techniques are adopted to control perioperative pain, these techniques include drugs as opioids and adjuvants as well as regional blocks. Erector spinae plane block is a regional technique that is used efficiently to control perioperative pain during and following breast cancer surgeries. Adding adjuvant drugs as dexmedetomidine or dexamethasone can augment the local anesthetic effect for the regional block used.

Official Title
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Comparison of Dexmedetomidine and Dexamethasone as Adjuvant to Bupivacaine in Ultrasound-guided Bilevel Erector Spinae Plane Block in Modified Radical Mastectomy

Conditions
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Analgesia

Intervention / Treatment
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* Procedure: Bilevel Erector spinae plane block
* Procedure: Bilateral Erector spinae plane block with dexamethasone
* Procedure: Bilateral Erector spinae plane block with dexmedetomidine
* Drug: Intravenous morphine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Female patients scheduled for Modified Radical Mastectomy MRM Physical status ASA II, III. Age (18-65) years Body mass index (BMI): (20-35) kg/m2. Exclusion Criteria: Patient refusal. Age <18 years or >65 years. BMI <20 kg/m2 and >35 kg/m2. Known sensitivity or contraindication to drug used in the study (local anaesthetics, opioids, dexamethasone, dexmedetomedine).

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Intravenous morphine<br>Patients will receive intravenous morphine 0.1 mg/kg | Drug: Intravenous morphine<br>* Intravenous morphine 0.1 mg/kg<br>* Other names: Morphine;|
| Experimental: Bilevel erector spinae plane block<br>Patients will receive erector spinae plane block at 2 levels | Procedure: Bilevel Erector spinae plane block<br>* Patients will receive bilevel erector spinae plane block with bupivacaine<br>* Other names: BileveL ESPB;|
| Experimental: Bilevel erector spinae plane block with dexamethasone<br>Patients will receive erector spinae plane block at 2 levels with dexamethasone | Procedure: Bilateral Erector spinae plane block with dexamethasone<br>* Patients will receive bilevel erector spinae plane block with bupivacaine and dexamethasone<br>* Other names: Bilevel ESPB with dexamethasone;|
| Experimental: Bilevel erector spinae plane block with dexmedetomidine<br>Patients will receive erector spinae plane block at 2 levels with dexmedetomidine | Procedure: Bilateral Erector spinae plane block with dexmedetomidine<br>* Patients will receive bilevel erector spinae plane block with bupivacaine and dexmedetomidine<br>* Other names: Bilevel ESPB with dexmedetomidine;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total morphine consumption in the first 24 hours postoperatively. | Assessment of total postoperative morphine consumption | First 24 hours postoperatively |