This clinical study aims to determine which of two medications-dexamethasone or dexmedetomidine-works better and is safer when used together with a local anesthetic (ropivacaine) in a type of nerve block called the erector spinae plane block (ESPB). This block helps reduce pain after lumbar spine surgery.
Adults aged 18 to N/A (no limit)
Scheduled for elective lumbar spine surgery (e.g., decompression or fusion) via posterior approach
American Society of Anesthesiologists (ASA) physical status I-III
Body weight ≥ 50 kg
Known allergy or contraindication to ropivacaine, dexamethasone, or dexmedetomidine
Infection at or near the site of block placement
Coagulation disorders or current use of anticoagulant therapy (not discontinued per guidelines)
Chronic opioid use or opioid dependence
Parallel
0.9%NaCl
Drug2 x 20ml 0.2% ropivacaine with 2ml of 0.9% NaCl
Dexamethasone 4mg
Drug2 x 20ml 0.2% ropivacaine with 2mg of dexamethasone
Dexmedetomidine
Drug2 x 20ml 0.2% ropivacaine with 25ug Dexmedetomidine
Total opioid Consuption
Cumulative opioid consumption during the first 24 and 48 hours after surgery, converted to morphine milligram equivalents (MME)
NRS
Numerical Rating Scale (0 - no pain; 10 - the worst pain ever)
NRS
Numerical Rating Scale (0 - no pain; 10 - the worst pain ever)
NRS
Numerical Rating Scale (0 - no pain; 10 - the worst pain ever)
NRS
Numerical Rating Scale (0 - no pain; 10 - the worst pain ever)
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