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The aim of this study to determine the optimal dose of dexmedetomidine as an adjuvant to bupivacaine in U.S guided TAP block for preemptive analgesia In patients undergoing lower abdominal cancer surgeries.
The transversus abdominis plane (TAP) involves innervations of the anterolateral abdominal wall derived from T6-L1. The block can be given either by anatomical landmark technique or by using an ultrasound probe. The local anesthetic is deposited in a plane between internal oblique and transversus abdominis muscle. It provides adequate postoperative analgesia following various abdominal surgeries.Dexmedetomidine is an alpha-2 agonist that has been approved as a venous sedative and an adjuvant for pain relief .In previous studies, the addition of dexmedetomidine to bupivacaine in the TAP block has prolonged the effect of this block . So far, the optimal dose of dexmedetomidine for the TAP block has not been determined.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| tap block with 0.5 μg/kg dexmedetomidine | Active Comparator | will receive pre-emptive ultrasound-guided tap block with 0.5 μg/kg dexmedetomidine in 20 ml volume added to 20 mL of 0.25% bupivacaine (40 ml in total) 20 ml will be applied on each side of the abdominal wall after induction of GA. |
|
| tap block with 1.5 μg/kg dexmedetomidine | Active Comparator | will receive pre-emptive ultrasound-guided tap block with 1.5 μg/kg dexmedetomidine in 20 ml volume added to 20 mL of 0.25% bupivacaine (40 ml in total) 20 ml will be applied on each side of the abdominal wall after induction of GA. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dexmedetomidine as adjuvent to bupvacaine in tap block | Drug | The analgesic effect of Two different doses of dexmedetomidine as adjuvent to bupivacaine in tap block |
|
| Measure | Description | Time Frame |
|---|---|---|
| Total morphine consumption during the first 24 hours postoperatively | Morphine consumption during the First 24 hours postoperative | First 24 hours postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Severity of pain using Visual analogue scale | The severity of pain at rest and on coughing will be assesd using a 10-cm vas(0 means no pain ,10 means worst pain) | First 24 hours postoperative |
| Patient level of sedation using four point modified ramsy scale |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Kerolos S Tawfeek, Resident | Contact | +2001551990411 | Kerolossalama7@gmail.com | |
| Mohanad A Mohamed | Contact | +2001027068866 | Mohanad.abosagheer@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Kerolos S Tawfeek | Assiut University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| South egypt cancer institute,Assiut University | Asyut | 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 |
|---|---|
| D020927 | Dexmedetomidine |
| ID | Term |
|---|---|
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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Patients will receive pre-emptive ultrasound-guided tap block with two different doses of dexmedetomidine in 20 ml volume added to 20 mL of 0.25% bupivacaine (40 ml in total) 20 ml will be applied on each side of the abdominal wall after induction of GA.
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using a 4-point scale (0 = awake and alert, 1 = minimally sedated, responds to speech, 2 = moderately sedated, arousable by tactile stimulation, and 3 = deeply sedated, arousable only by painful stimulation) |
| First 24 hours postoperative |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |