Aim of the study:
The current study aims to compare the effect of adding dexamethasone versus magnesium sulfate to bupivacaine in ultrasound-guided erector spinae plane block on the severity of postoperative pain.
Primary Objectives:
\- To compare the effect of ESPB without additives to the effect of adding dexamethasone and to the impact of adding magnesium sulfate in the form of post-operative morphine consumption
Adult (18 - 65)
Patients undergoing unilateral nephrectomy
ASA II / III
Patient refusal
Age less than 18 years
Allergy to any of the studied medications
Mid line incision
Parallel
ultrasound guided Erector Spinae Plane Block using 27ml bupivacaine 0.25%
Procedure/SurgeryESP block will be performed U/S at the level of T 10 paraspinal level. The ultrasound transducer should be placed in the midline of the back at the desired level. The probe should then slowly be moved laterally until the transverse process is visible. The transverse process requires differentiation from the rib at that level. Erector spinae muscle should be identified superficial to the transverse process. The needle inserted superior to the ultrasound probe in the cephalad to caudal direction. Once the needle tip is below the erector spinae muscle. This separation from the transverse process confirms the proper needlemposition. The local anesthetic should then be injected in 5 ml increments. The block will be performed preoperatively.
postoperative opioid consumption
total postoperative rescue analgesia be by Morphine
time of first rescue analgesia
Ketorolac 30 mg I.V infusion if VAS is between 3 to 6, and Morphine 3 mg I.V if VAS equals or greater than 6
Intraoperative opioid consumption
total Intraoperative rescue analgesia will be done by giving fentanyl at dose of 1 mic/Kg
visual analogue scale 30 hours post-operatively at rest
visual analogue scale from 0 to 10 as 0 no pain and 10 worst pain
Click on the lead sponsor to view all of their trials.
