Effect of Dexmedetomidine Versus Dexamethasone as Adjuvant to Bupivacaine in Ultrasound Guided Erector Spinae Plane Block on Postoperative Analgesia in Myasthenic Patients Undergoing Thoracoscopic Thymectomy

Effect of Dexmedetomidine Versus Dexamethasone as Adjuvant to Bupivacaine in Ultrasound Guided Erector Spinae Plane Block on Postoperative Analgesia in Myasthenic Patients Undergoing Thoracoscopic Thymectomy

This current comparative study involved 54 patients undergoing thoracoscopic thymectomy who were distributed randomly into three equal groups to receive ultrasound (US)-guided ESPB using 20 ml bupivacaine 0.25% (group B) , 20 ml bupivacaine 0.25% with 8 mg dexamethasone (group BS), 20 ml bupivacaine 0.25% with dexmedetomidine 1mcg/kg (group BM). The time till the first postoperative rescue analgesic requested was the primary outcome. The secondary outcomes included the postoperative pain scores and analgesic consumption.

Inclusion Criteria:

• myasthenic patients
• American Society of Anesthesiologists (ASA) physical grade of 2-3)
• who underwent video assisted thoracoscopic thymectomy

Exclusion Criteria:

• Refused participation in the study,
• known allergy for this study drugs ,
• Contraindication to the ESPB as infection at block site & marked chest cage deformity,
• significant bleeding disorders ,
• patients with significant renal or liver dysfunction,
• heart block ,
• poor ventilatory function,
• severe chronic obstructive pulmonary disease,
• morbid obesity,
• mental disability, or communication difficulties that hindered effective pain assessment,
• Individuals who was converted to open thoracotomy or those re-explorated for surgical related issues.