Dexmeditomedine as an Adjuvant to Levobupivacaine in Transversus Thoracis Plane Block on the Management of Post-sternotomy Pain in Open-heart Surgeries

Dexmeditomedine as an Adjuvant to Levobupivacaine in Transversus Thoracis Plane Block on the Management of Post-sternotomy Pain in Open-heart Surgeries

the study is to assess the efficacy of dexmeditomedine as an adjuvant to the local anaesthetic levobupivacaine in transversus thoracis plane block given bilaterally on the management of post-sternotomy pain.

the patients will fall into one of two groups using an online randomizer. this study is an assessor-blinded interventional controlled study. the first group will recieve transversus thoracis plane block bilaterally where 15 ml of 0.25% levobupivacaine will be given. and the other group shall also undergo a bilateral transversus thoracis plane block with 15 ml 0.25% levobupivacaine and 0.05 ug/kg dexmeditomedine on each side. the primary aim of the study is the 24 hour post-operative morphine consumption.

Inclusion Criteria:

• Adult patients > 20 years old.
• ASA II to III patients undergoing elective cardiac surgery via a median sternotomy

Exclusion Criteria:

• Patient's refusal.
• Known contraindications to regional blocks, including local skin infections,and coagulopathy.
• Allergies to the local anaesthetics used.
• Patients undergoing complex cardiac procedures.
• Patients with severe chronic obstructive pulmonary disease.
• Patients unable to communicate.
• Patients with chronic pain.
• Patients with severe pulmonary hypertension.