Effectiveness of Combining Erector Spinea Block With Non Opioid Infusions as Opioid Free Anesthesia in Spine Surgeries.

Study Overview
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Brief Summary
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opioid free anesthesia consists of combination of pharmacological and non pharmacological modalities that target different pathways of pain mechanism. combining myofascial plane blocks with infusion of adjuvants such as lidocaine or dexmedetomidine can offer equivalent intraoperative hemodynamic stability compared to that of opioid with better pain control postoperatively. this study will investigate the efficacy of combined erector spina block with lidocaine and dexmedetomidine infusion as opioid sparing anesthesia in spine surgeries

Detailed Description
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patients who will undergo spine surgery will be allocated into two groups. after general anesthesia, bilateral erector spine block will be applied in both groups. group A will have intraoperative fentanyl infusion and group B will have lidocaine and dexmedetomidine infusion in 50 ml syringe till end of surgery

Official Title
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Assistant Professor of Anesthesia, Intensive Care and Pain Management

Conditions
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Opioid Use, Spine Fusion

Intervention / Treatment
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* Drug: fentanyl infusion after general anesthesia and erector spinea block
* Drug: lidocaine 2% and dextometometidine infusion after general anesthesia and erector spinea block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - spine surgery ASAI,II Exclusion Criteria: revision surgery hypotension bradycardia

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

Sexes Eligible for Study
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All

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: traditinal balanced anesthesia<br>fentanyl infusion after general anesthesia and erector spinea block | Drug: fentanyl infusion after general anesthesia and erector spinea block<br>* intraoperative opioid infusion in active comparative group<br>* Other names: opioid infusion;|
| Experimental: opioid free anesthesia<br>lidocaine and dextometidine infusion after general anesthesia and erector spinea block | Drug: lidocaine 2% and dextometometidine infusion after general anesthesia and erector spinea block<br>* intraoperative non opioid infusion in experimental group<br>* Other names: lidocaine 2% and precedex infusion;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| number of patients (percentage) having intraoperative systolic hypertension | blood pressure more than 160 mmhg | during operation(intraoperatively) | 
| number of patients(percentage) having tachycardia | heart rate more than 100 beat /minute | during operation(intraoperatively) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| VAS score | score from 0 to 10, 0 is no pain and 10 the worst pain | every 30 minutes for 2 hours postoperatively | 
| incidence of bradycardia | heart rate less than 45 beat per minute | intraoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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multimodal analgesia, regional blocks, spine surgeries