RESEARCH ARTICLE


Effect of Adding Dexmedetomidine to Bupivacaine in Ultrasound Guided Rectus Sheath Block: A Randomized Controlled Double-blinded Study



Wafaa T Salem1, Khaled A Alsamahy1, Wael A Ibrahim1, Abear S Alsaed2, Mohamed M Salaheldin1, *
1 Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt
2 Department of Clinical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt


© 2019 Salem et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Egypt Fom EL Khaleeg, Cairo, Egypt; Tel: +20237604220; Email: mail@mcs-center.com


Abstract

Background:

Extended midline laparotomy incision is accompanied by intense pain postoperatively which affects patients’ physiology; therefore, good control of postoperative pain is mandatory to decrease the adverse effects on the body. Ultrasound-guided Bilateral Rectus Sheath Block (BRSB) is one of the options to achieve this goal.

Objective:

The study aimed to assess the analgesic potency of adding dexmedetomidine to bupivacaine in ultrasound-guided BRSB in cancer patients with a midline laparotomy incision.

Methods:

Sixty adult cancer patients planned for laparotomies with extended midline incision were included. Ultrasound-guided BRSB was performed immediately after the induction of anesthesia.

Patients were classified randomly into two groups; B group, where only bupivacaine was used for BRSB and BD group in whom a mixture of bupivacaine and dexmedetomidine was used.

Results:

A significant decrease in visual analogue scale scores, total morphine consumption, postoperative nausea and vomiting and postoperative cortisol levels was observed in group BD.

Conclusion:

Dexmedetomidine as an adjuvant to bupivacaine in US-guided rectus sheath block bilaterally proved to be effective for proper pain management postoperatively in cancer patients after extended midline abdominal incision.

Keywords: Rectus sheath block, Dexmedetomidine, Pain, Regional anesthesia, Midline abdominal incision, Abdominal cancers.