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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
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
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| traditinal balanced anesthesia | Active Comparator | fentanyl infusion after general anesthesia and erector spinea block |
|
| opioid free anesthesia | Experimental | lidocaine and dextometidine infusion after general anesthesia and erector spinea block |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| fentanyl infusion after general anesthesia and erector spinea block | Drug | intraoperative opioid infusion in active comparative group |
|
| 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) |
| 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 |
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Inclusion Criteria:
- spine surgery ASAI,II
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| sanaa wasfy, professor | Contact | 01061262757 | sanaawasfy@gmail.com | |
| wael behairy, professor | Contact | 01282269727 | wailbehairy@yahoo.com |
| Name | Affiliation | Role |
|---|---|---|
| sanaa wasfy, professor | assistant professor of anesthesia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ainshams hospitals | Cairo | 11591 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 5285383 | Background | Rowland M, Thomson PD, Guichard A, Melmon KL. Disposition kinetics of lidocaine in normal subjects. Ann N Y Acad Sci. 1971 Jul 6;179:383-98. doi: 10.1111/j.1749-6632.1971.tb46915.x. No abstract available. |
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|
| lidocaine 2% and dextometometidine infusion after general anesthesia and erector spinea block | Drug | intraoperative non opioid infusion in experimental group |
|
|
| intraoperatively |
| ID | Term |
|---|---|
| D008012 | Lidocaine |
| ID | Term |
|---|---|
| D000083 | Acetanilides |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
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