الفهرس 
BUPIVACAINEOnly 14 pages are availabe for public view
 |  | from | 96 |  |  |
| | | from | 96 | | |
Abstract
• Ultrasound guided ESPB provides adequate postoperative analgesia for patients undergoing lumbar spine surgeries.
• Additives such as magnesium sulphate and dexmedetomidine increase the duration of postoperative analgesia provided by the ESP block and decrease postoperative opioid requirements and as well its side effects.
• The use of dexmedetomidine as an adjuvant to bupivacaine in the ultrasound guided ESP block associated with more patients satisfaction, but with a significant reduction in MAP as well as in HR, compared to MG.
• No significant difference regarding opioid consumption has been recorded between both groups.
LIMITATIONS
Our study had some limitations:
• Small sample size.
• Relative bradycardia and hypotension resulting from the dexmedetomidine dose we used.
• Postoperative hospital stay wasn’t recorded.
RECOMMENDATIONS
Based on the findings of the current study, the following suggestions are recommended:
• Dexmedetomidine could be used as a promising adjuvant to bupivacaine for erector spinae plane block in the context of lumbar spine surgeries.
• Further studies should be conducted in the future on large number of cases to find the optimal dose with least hemodynamic side effects.
• Future studies using a catheter for longer period of analgesia.
• Ultrasound guided ESP block among high-risk groups, such as obese, elderly, and patients with comorbidities should be tried.
• The study of 3rd group using only bupivacain to be a control group.
SUMMARY
Erector spinae plane block is a relatively novel approach to pain management for a variety of surgical procedures, as well as for acute and chronic pain. It is performed as a single injection block, or a catheter placement for continues pain relief, mostly done with ultrasound guidance.
Ultrasound became the more favored device for locating nerve’s structure to achieve plexus and nerve blocks. US is desirable to progress effectiveness and decrease the complication of plexus blocks.
Additives such as magnesium sulphate and dexmedetomidine have been suggested to increase the duration of postoperative analgesia. Magnesium sulphate (MG) is the NMDA receptor adversary that was assessed as an adjunct to local anesthetics in the neuraxial blocks and marginal nerve blocks. There is evidence that dexmedetomidine (DEX) decreases postoperative pain, postoperative opioid usage, and nausea.
Aim of the study
The aim of the current study was to compare the effect of adding magnesium sulphate or dexmedetomidine to bupivacaine in ultrasound guided erector spinae block for postoperative analgesia after lumbar spine surgeries.
Study design
This study was a prospective, randomized, double-blind comparative study carried out on a total of 52 ASA I and II patients who undergone lumbar spine surgeries at Ain Shams University Hospitals during the period from July 1st, 2021, until June 30th, 2022.
The current study revealed the following outcomes
• DEX group was associated with a significant reduction in MAP as well as in HR, thus dexmedetomidine group was associated with a possibility of bradycardia and hypotension compared with MG group.
• from 4th to 6th hour postoperative, there were statistically significant increases in VAS score in MG group compared to DEX group.
• DEX group was not associated with significant difference in total dose of nalbuphine required compared to MG group.
• DEX group was associated with a significant increase in satisfactory outcomes compared to MG group.
• No recorded complications in both groups.