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In this study the investigators will investigate the efficacy of ESPB as a part of Enhanced recovery after surgery on postoperative analgesia and recovery criteria after off pump cardiac surgery.
General anaesthesia will be induced by 0.05 mg/kg midazolam, 3 µg/kg fentanyl, 1-2mg/kg propofol, and 0.5mg/kg of Atracurium. After induction, bilateral erector spinae plane block will be performed in the block group. Intraoperative analgesia will be achieved by fentanyl boluses of 0.5-to-1 µg/kg titrated according to haemodynamic parameters. Postoperative analgesia will be managed by paracetamol 1000 mg /6hours and morphine 1-2mg boluses when pain score ≥4 1 to 2 mg to be repeated every 5 minutes if needed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Erector spinae block group | Active Comparator | the patients will be administered bilateral Erector spinae block with 20 ml of 0.25 % bupivacaine |
|
| control group | Other | no block will be done but only IV analgesia. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Erector spinae block | Procedure | After induction, the patients will be administered bilateral Erector spinae block with 20 ml of 0.25 % bupivacaine |
|
| Measure | Description | Time Frame |
|---|---|---|
| Total intraoperative and postoperative opioid consumption | Microgram and mg | 48 hours |
| Measure | Description | Time Frame |
|---|---|---|
| pain intensity at rest and movement | numerical rating score from zero to ten ( 0=no pain, 10 =severe pain ) | 48 hours |
| time to first rescue analgesia | minutes |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Islam M ElDesoky, MD | Menoufia University | Principal Investigator |
| AMAL G SAFAN, MD | Menoufia University | Principal Investigator |
| Abd-Elazeem A Elbakry, MD | Menoufia University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Menoufia university | Cairo | Shibin Elkom | Egypt |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| ID | Term |
|---|---|
| D005283 | Fentanyl |
| ID | Term |
|---|---|
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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| Fentanyl | Drug | fentanyl boluses of 0.5-to-1 µg/kg titrated according to haemodynamic parameters. |
|
| 24hous |
| Duration of mechanical ventilation | hours | 24 hours |
| time to extubation | min | 24hours |
| time to ambulation | hours | 24hours |
| time to oral intake | hours | 48 hours |
| time of chest drain removal | hours | 5 days |
| time of intensive care unit stay | hours | one week |
| The heart rate | Beats per minutes | 48 hours |
| mean arterial blood pressure | mmHg | 48 hours |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |