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This study,will evaluate the efficacy of ultrasound (US)-guided subcostal oblique TAP block together with IV infusion of Dexmedetomidine and fentanyl as a type of multimodal analgesic regimen in comparison with IV fentanyl based analgesia only in live liver donors.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group F | Active Comparator | Fentanyl infusion (0.5 µg/kg/hr) |
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| Group (TAP-Dex) | Active Comparator | Ultrasound guided TAP block and Dexmedetomidine
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fentanyl infusion | Drug | After induction of general anesthesia; Fentanyl infusion (0.5 µg/kg/hr) will be started (which will be afterwards adjusted intraoperatively according to the hemodynamics and Bispectral Index (BIS) reading). |
| Measure | Description | Time Frame |
|---|---|---|
| Total fentanyl consumption | Total Intravenous fentanyl consumption during the operation | Intraoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Average sevoflurane concentration | The average sevoflurane concentration (the average concentration (%) for the case will be determined from the vaporizer setting recorded in the anesthetic record per 5-minute interval) | Intraoperative |
| The severity of postoperative nausea and vomiting (PONV) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospitals of Faculty of Medicine , Ain Shams University | Cairo | 11591 | Egypt |
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| ID | Term |
|---|---|
| D000701 | Analgesics, Opioid |
| D000765 | Anesthesia, Conduction |
| D020927 | Dexmedetomidine |
| ID | Term |
|---|---|
| D009294 | Narcotics |
| D002492 | Central Nervous System Depressants |
| D045505 | Physiological Effects of Drugs |
| D020228 | Pharmacologic Actions |
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| Ultrasound guided TAP block | Procedure | After induction of general anesthesia; Patients will receive ultrasound guided subcostal oblique TAP block with 0.25 % bupivacaine 40 ml on each side resulting in a total volume of 80 ml, subcostal TAP block was given twice, at the beginning and at the end of the surgery. |
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| Dexmedetomidine | Drug | Dexmedetomidine (200 µg in 2 ml diluted in 48 ml of saline) will be started in a dose of 1 μg/kg over 10 min then maintenance dose as continuous infusion between 0.2 and 0.8 μg/ kg/h through infusion pump (which will be adjusted according to the hemodynamics and BIS reading) |
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Will be recorded and classified as "no PONV, mild PONV, moderate PONV and severe PONV" |
| First 24 hours postoperatively |
| Ramsay sedation score (RSS) | Will be used for assessment of sedation immediately after extubation, after 2 hours of ICU admission, after 12 hours then after 24 hours . | First 24 hours postoperatively |
| D020164 | Chemical Actions and Uses |
| D000700 | Analgesics |
| D018689 | Sensory System Agents |
| D018373 | Peripheral Nervous System Agents |
| D002491 | Central Nervous System Agents |
| D045506 | Therapeutic Uses |
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |