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Opioid-free intraoperative protocols have been successfully used in specific surgical populations with equal or superior results to classic general anesthetic approaches. In instances where opioid-free anesthesia may not be entirely feasible, there exists a continually growing body of evidence that the modern anesthesiologist has a potent pharmacologic and regional anesthetic arsenal that can reduce the amount of opioids required to effectively treat pain.
Retrolaminar block is considered a new, easy and simple technique with decreasing incidence of complications such as hypotension, pleural and nerve injury. Its efficacy had been investigated in trauma patients
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard analgesia (paracetamol +fentanyl) | Active Comparator | Patients will receive standard analgesia (paracetamol 15mg/kg plus fentanyl 1ug/kg) iv |
|
| Retrolaminar block with bupivacaine + magnesium sulfate + dexamethasone | Active Comparator | Patients will receive intraopertative retrolaminar block: 15 ml of bupivacaine 0. 25 % plus 2ml magnesium sulfate 10% (200mg) plus 2ml (8mg) dexamethasone on each side by slipping the needle of injection on the bone of spinous process and lamina. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Standard analgesia (paracetamol +fentanyl) | Procedure | Patients will receive standard analgesia (paracetamol 15mg/kg plus fentanyl 1ug/kg) iv |
|
| Measure | Description | Time Frame |
|---|---|---|
| The recovery time | The recovery time (time from discontinuation of isoflurane to first response to verbal command) will be recorded, then the patient will be transferred to the post anesthesia care unite (PACU) on standard monitors. | up to 1 hour postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| pain intensity | pain intensity measured using visual analogue scale from 0= no pain to 10= worst pain | up to 24 hours postoperative |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Alshaimaa Kamel, M.D | Zagazig University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Human Medicine, Zagazig University | Zagazig | Alsharquia | 44511 | Egypt |
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| ID | Term |
|---|---|
| D002045 | Bupivacaine |
| D008278 | Magnesium Sulfate |
| D003907 | Dexamethasone |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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| Retrolaminar block with bupivacaine + magnesium sulfate + dexamethasone | Procedure | Patients will receive intraopertative retrolaminar block: 15 ml of bupivacaine 0. 25 % plus 2ml magnesium sulfate 10% (200mg) plus 2ml (8mg) dexamethasone on each side by slipping the needle of injection on the bone of spinous process and lamina. |
|
| D000588 |
| Amines |
| D017616 | Magnesium Compounds |
| D007287 | Inorganic Chemicals |
| D013431 | Sulfates |
| D013464 | Sulfuric Acids |
| D013456 | Sulfur Acids |
| D013457 | Sulfur Compounds |
| D011246 | Pregnadienetriols |
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D013259 | Steroids, Fluorinated |