drugset / Trial / NCT06490614
Dexmedetomidine and Nalbuphine as Analgesic Adjuvants to Bupivacaine in Superficial Cervical Block.
RandomizedParallel-groupDouble-blindSupportive care
Summary
Anterior cervical discectomy and fusion (ACDF) nowadays is considered a common procedure.postoperative pain can hinder recovery and prolong hospital stay. The superficial cervical plexus block (SCPB) is a safe and simple technique that had been found to allow good pain relief in neck surgeries. The main drawback of SCPB was short duration, so adjuvants as dexmedetomidine and opioids has been used to increase analgesic duration and decrease the use of opioids. The current study will compare the efficacy of dexmedetomidine and nalbuphine as adjuvants to bupivacaine in SCPB in anterior cervical fusion surgeries.
Timeline
- Start
- 2024-07
- Primary completion
- 2024-10
- Completion
- 2024-11
Publications
- Background Rostami M, Moghadam N, Obeid I, Jouibari MF, Zarei M, Moosavi M, Khoshnevisan A, Farahbakhsh F, Moosaie F, Ehteshami S, Borghei A, Shafizadeh M, Kordi R, Khadivi M. The Impact of Single-Level Anterior Cervical Discectomy and Fusion on Cervical Sagittal Parameters and Its Correlation With Pain and Functional Outcome of Patients With Neck Pain. Int J Spine Surg. 2021 Oct;15(5):899-905. doi: 10.14444/8115. Epub 2021 Oct 8.
- Background McGirt MJ, Rossi V, Peters D, Dyer H, Coric D, Asher AL, Pfortmiller D, Adamson T. Anterior Cervical Discectomy and Fusion in the Outpatient Ambulatory Surgery Setting: Analysis of 2000 Consecutive Cases. Neurosurgery. 2020 Mar 1;86(3):E310-E315. doi: 10.1093/neuros/nyz514.
- Background Garringer SM, Sasso RC. Safety of anterior cervical discectomy and fusion performed as outpatient surgery. J Spinal Disord Tech. 2010 Oct;23(7):439-43. doi: 10.1097/BSD.0b013e3181bd0419.
- Background Arnold PM, Rice LR, Anderson KK, McMahon JK, Connelly LM, Norvell DC. Factors affecting hospital length of stay following anterior cervical discectomy and fusion. Evid Based Spine Care J. 2011 Aug;2(3):11-8. doi: 10.1055/s-0030-1267108.
- Background Mariappan R, Mehta J, Massicotte E, Nagappa M, Manninen P, Venkatraghavan L. Effect of superficial cervical plexus block on postoperative quality of recovery after anterior cervical discectomy and fusion: a randomized controlled trial. Can J Anaesth. 2015 Aug;62(8):883-90. doi: 10.1007/s12630-015-0382-3. Epub 2015 Apr 14.
- Background Woldegerima YB, Hailekiros AG, Fitiwi GL. The analgesic efficacy of bilateral superficial cervical plexus block for thyroid surgery under general anesthesia: a prospective cohort study. BMC Res Notes. 2020 Jan 28;13(1):42. doi: 10.1186/s13104-020-4907-7.
- Background Mulcahy MJ, Elalingam T, Jang K, D'Souza M, Tait M. Bilateral cervical plexus block for anterior cervical spine surgery: study protocol for a randomised placebo-controlled trial. Trials. 2021 Jun 29;22(1):424. doi: 10.1186/s13063-021-05377-4.
- Background Hassan AH, Amer IA, Abdelkareem AM. Comparative study between dexmedetomidine versus dexamethasone as adjuvants to levobupivacaine for cervical plexus block in patients undergoing thyroid operation. prospective-randomized clinical trial. The Egyptian Journal of Hospital Medicine. 2021 Jul 1;84(1):1638-43.
- Background Al-Mustafa MM, Abu-Halaweh SA, Aloweidi AS, Murshidi MM, Ammari BA, Awwad ZM, Al-Edwan GM, Ramsay MA. Effect of dexmedetomidine added to spinal bupivacaine for urological procedures. Saudi Med J. 2009 Mar;30(3):365-70.
- Background Vuyk J, Sitsen E, Reekers M. Intravenous Anesthetics. In: Miller RD, Eriksson LI, Cohen NH, Fleisher LA, Wiener-Kronish JP, Young WL, editors. Miller's Anesthesia. 8th ed. Philadelphia: Elsevier Churchill Livingstone; 2015. pp. 854-9
- Background Brummett CM, Hong EK, Janda AM, Amodeo FS, Lydic R. Perineural dexmedetomidine added to ropivacaine for sciatic nerve block in rats prolongs the duration of analgesia by blocking the hyperpolarization-activated cation current. Anesthesiology. 2011 Oct;115(4):836-43. doi: 10.1097/ALN.0b013e318221fcc9.
- Background Richard B, Alan JR, Vincent WS, Miller RD, Eriksson LI, Wiener-Kronish JP, Young WL. Spinal, epidural, and caudal anesthesia. Miller's anesthesia. 8th ed. Philadelphia, PA: Saunders, an imprint of Elsevier Inc. 2015:1684-720.
- Background Omar Mostafa M, Makram Botros J, Sayed Khaleel AM. Effect of Dexmedetomidine Versus Nalbuphine as an Adjuvant on Paravertebral Block to Manage Postoperative Pain After Mastectomies. Anesth Pain Med. 2018 Apr 28;8(2):e13308. doi: 10.5812/aapm.13308. eCollection 2018 Apr.
- Background Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, Fainsinger R, Aass N, Kaasa S; European Palliative Care Research Collaborative (EPCRC). Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage. 2011 Jun;41(6):1073-93. doi: 10.1016/j.jpainsymman.2010.08.016.
- Background Chinnappa V, Chung F.What Criteria Should Be Used for Discharge after Outpatient Surgery?. InEvidence-Based Practice of Anesthesiology 2013 Jan 1 (pp. 343-351).
- Background Shi W, Dong J, Chen JF, Yu H. A meta-analysis showing the quantitative evidence base of perineural nalbuphine for wound pain from upper-limb orthopaedic trauma surgery. Int Wound J. 2023 May;20(5):1476-1490. doi: 10.1111/iwj.14002. Epub 2022 Nov 3.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Subject | Dexmedetomidine | Other / unclassified | 1 ug/kg | Subcutaneous |
| Subject | Nalbuphine | Small molecule | 10 mg | Subcutaneous |
| Background | Bupivacaine | Other / unclassified | 0.25 % | Subcutaneous |
| Background | Epinephrine | Other / unclassified | — | Subcutaneous |
Indications
No indication recorded.