Double Level Lumbar Spondylolisthesis (L3-L5) Clinical Trial
Official title:
Effect of Addition of Dexmedetomidine During Ultrasound Guided Bilateral Single Shot Erector Spinae Plane Block in Patients Undergoing Posterior Lumbar Interbody Fusion Under General Anesthesia
Posterior lumbar interbody fusion (PLIF) is the management of choice in double level lumbar (L) spondylolisthesis (L3-L5) after ineffective conservative treatment. We evaluated bilateral ultrasound (US)-guided single shot erector spinae plane (ESP) block at the level of lumbar 3 (L3) vertebra with or without dexmedetomidine (Dex).
Objectives: Posterior lumbar interbody fusion (PLIF) is the management of choice in double
level lumbar (L) spondylolisthesis (L3-L5) after ineffective conservative treatment. We
evaluated bilateral ultrasound (US)-guided single shot erector spinae plane (ESP) block at
the level of lumbar 3 (L3) vertebra with or without dexmedetomidine (Dex).
Methods: A prospective controlled randomized, double-blind study comparing two groups of
patients; each group included 20 patients of double level spondylolisthesis (L3-L5) scheduled
for (PLIF) under general anesthesia combined with bilateral US-guided ESP single shot block
at (L3). Group I received 20 ml of 0. 25% bupivacaine plus one mL normal saline bilaterally.
Group II received 20 ml of 0.25% bupivacaine with supplementation of 1 mL containing 100µg
dexmedetomidine bilaterally. Post-Anesthesia Care Unit (PACU) length of stay, the total dose
of postoperative analgesics need, postoperative visual analogue score (VAS) at 1h, 6h, 12h,
and 24 h after the operation and postoperative complications which related to block or
opioids were recorded.
ESP block at combined with (Dex) is a safe, effective block with no complications. Addition
of 100µg Dex to preoperative ESP block provided good postoperative opioid-sparing analgesia,
facilitated the early emergence and shortened the length of stay in the PACU during (PLIF)
for double level spondylolisthesis (L3-L5).
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