Surgical trauma activates numerous receptors leading to severe postoperative pain. Seventy to seventy-five percent of the pain is somatic, originating from the anterior abdominal wall, and it often persists for 72 hours after open surgery. The objective of this study is to compare the efficacy and safety of adding dexmedetomidine to Levobupivacaine in rectus sheath block with quadrates lumborum block in patients undergoing lower abdominal cancer surgeries.
Patients subjected to major lower abdominal cancer surgeries.
The enrolled age will be from 18 years to 70 years
ASA I-III and NYHA I-III.
ASA physical status >III and NYHA>III
Patient refusal
Body mass index >40 kg/m2
Preoperative opioid consumption
Parallel
Levobupivacaine
Drug40-ml mixture of 20 ml of 0.5% levobupivacaine diluted with 20 ml of 0.9% N.S. (20 ml to be injected on each side
Levobupivacaine + Dexmedetomidine
Drug60 ml mixture of 1.5 mic/kg dexmedetomidine added to 30 ml of 0.5% levobupivacaine diluted with 30 ml of 0.9% N.S. (30 ml to be administered on each side, divided into 15 ml for the upper segment and 15 ml for the lower segment).
pain intensity
measured by VAS immediately postoperatively, then at 2-, 4-, 6-, 8-, 12-, 18-, 24-hours after surgery.
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