Pain, Postoperative Clinical Trial
Official title:
Safety and Efficacy of Ultrasound Guided Paravertebral Dexmedetomidine for Postoperative Pain Relief in Video Assisted Thoracoscopy Surgery
Postoperative pain is the most undesired consequence of surgery, and if not managed adequately, can lead to delayed recovery and increased hospital stay. Surveys continue to reveal that postoperative pain is insufficiently managed throughout the first world, let alone in the Third World. An American survey over 20 years showed that only one in four patients had adequate relief of postoperative pain. This has led recovery room protocols to include pain as a fifth vital sign that needs to be addressed before patients are discharged to the ward
This prospective, randomized, double-blinded, parallel assignment clinical trial will be done
after receiving approval from the local ethics committee of the Faculty of Medicine, Assiut
University. A written informed consent will be taken after discussing a detailed description
of the study with the patients.
Patients will be allocated randomly into two equal groups by computer programs and will be
contained in sealed opaque envelopes.
Patients will be premedicated with midazolam (0.1mg/kg), 30 min before the operation.
Patients will be monitored with ECG, non-invasive blood pressure, heart rate, temperature,
oxygen saturation, exhaled CO2 (end tidal capnography), and train of four. In both groups,
general anesthesia will be induced with propofol (2mg/kg) and fentanyl (1 mcg/kg). Tracheal
intubation will be facilitated with cisatracurium 0.1 mg/kg. Anesthesia will be maintained
with isoflurane (1-2 %) and cisatracurium (0.05 mg/kg per dose). Fentanyl (0.5mcg/kg) will be
repeated if heart rate (HR) and/or mean arterial pressure (MAP) rise 20 % above baseline
values. After the end of anesthesia induction and before surgical procedure Technique of
ultrasound guided paravertebral block will be done in both groups.
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