Original research: Dexmedetomidine versus ketamine in erector spinae plane block for postoperative analgesia following modified radical mastectomy: A prospective randomized controlled blinded study | ||
| Egyptian Journal of Anaesthesia | ||
| Volume 40, Issue 1, December 2024, Pages 184-192 PDF (1.54 M) | ||
| DOI: TEJA-2023-0278 | ||
| Authors | ||
| Ehab Hanafy Shaker; Ahmed M Soliman; Ahmed Abd Elmohsen Bedewy; Suzan Adlan | ||
| Abstract | ||
| Background A significant postoperative pain has been documented in numerous breast cancer cases following modified radical mastectomy (MRM). We evaluated the effectiveness of dexmedetomidine (DEX) versus ketamine as adjuvants to local anaesthetic in erector spinae plane block (ESPB) in MRM. Methods In this randomized controlled trial, 75 women with breast cancer scheduled for MRM were included. All patients underwent ESPB with 30 ml 0.25% bupivacaine and randomized into three equal groups: group A, ESPB group; group B: received 1 µg/kg DEX with the ESPB; and group C: given 0.5 mg/kg Ketamine with the block. Results Compared with group A, VAS score at rest as well as movement were lower considerably in groups B and C ( < 0.05) at 6 h, 12 h, and 24 h. Group B had lower VAS scores at rest at 12 h and 24 h and during movement at 6 h, 12 h, and 24 h ( < 0.05) than group C. In comparison to A Group; B and C Groups required considerably less time to rescue analgesia and consumed significantly fewer total opioids ( < 0.05 and < 0.001, respectively). In addition, total number of patients who required additional analgesia was markedly reduced in groups B and C compared to group A ;( < 0.05). Conclusion In MRM surgery, the postoperative opioids consumption and VAS values were lower in both groups DEX and ketamine as an adjuvant to bupivacaine which enhanced the analgesic profile and prolonged ESPB duration compared to ESPB alone, with DEX being superior to ketamine. | ||
| Keywords | ||
| breast cancer; Dexmedetomidine; Ketamine; Erector spinae plane block; Pain | ||
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