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The purpose of this study is to compare better postoperative analgesia after lumbar spine Fixation using either epidural bupivacaine with midazolam or fentanyl with the combination of dexamethasone.
After being informed about the study and potential risks. A computer-generated randomization table will randomize all patients giving written consent into 2 groups, each containing 51 patients. In the Fentanyl Group :.Patients will receive 10 ml of bupivacaine 0. 25 % plus 100µg fentanyl in 2ml plus 2ml (8mg) dexamethasone.In Midazolam Group: Patients will receive 10 ml of bupivacaine 0.25 % plus 2mg midazolam in 2ml plus 2 ml (8mg) dexamethasone
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| fentanyl | Active Comparator | Patients will receive 10 ml of bupivacaine 0. 25 % plus 100µg fentanyl in 2ml plus 2ml (8mg) dexamethasone (14 ml total volume). |
|
| midazolam | Active Comparator | Patients will receive 10 ml of bupivacaine 0.25 % plus 2mg midazolam in 2ml plus 2 ml (8mg) dexamethasone with (14 ml total volume). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Epidural fentanyl | Drug | Fentanyl will be injected in the epidural space by the surgeon one or two levels above the surgical site. |
|
| Measure | Description | Time Frame |
|---|---|---|
| the time to first call to rescue analgesia (ketorolac) | day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| The Numerical Pain Rating Scale | A ten-centimeter Numerical Pain Rating Scale (0 - no pain and 10 - worst pain) | 24 hours postoperative] |
| The total postoperative opioid consumption in the first 24 hours. opioid consumption |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Medicine,Zagazig University | Zagazig | 44519 | Egypt |
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| epidural midazolam | Drug | midazolam will be injected in the epidural space by the surgeon one or two levels above the surgical site. |
|
| 24 hours postoperative |
| the duration of hospital stay | from the post operative day till discharge from hospital. | up to 1 week |