Abstract
Background: Extended midline laparotomy incision is accompanied by intense pain postoperatively which affects patients’ physiology; therefore, good control of postoperative pain is mandatory to decrease the adverse effects on the body. Ultrasound-guided Bilateral Rectus Sheath Block (BRSB) is one of the options to achieve this goal. Objective: The study aimed to assess the analgesic potency of adding dexmedetomidine to bupivacaine in ultrasound-guided BRSB in cancer patients with a midline laparotomy incision. Methods: Sixty adult cancer patients planned for laparotomies with extended midline incision were included. Ultrasound-guided BRSB was performed immediately after the induction of anesthesia. Patients were classified randomly into two groups; B group, where only bupivacaine was used for BRSB and BD group in whom a mixture of bupivacaine and dexmedetomidine was used. Results: A significant decrease in visual analogue scale scores, total morphine consumption, postoperative nausea and vomiting and postoperative cortisol levels was observed in group BD. Conclusion: Dexmedetomidine as an adjuvant to bupivacaine in US-guided rectus sheath block bilaterally proved to be effective for proper pain management postoperatively in cancer patients after extended midline abdominal incision.
Highlights
Over the past years, the concept of pain management has extended from decreasing pain intensity to optimizing patient’s condition
Dexmedetomidine as an adjuvant to bupivacaine in US-guided rectus sheath block bilaterally proved to be effective for proper pain management postoperatively in cancer patients after extended midline abdominal incision
Dexmedetomidine (DEX) is one of the α adrenoceptor agonists with α2 -adrenoceptor selectivity [11]. It has been shown as a valuable additive to local anesthetics in neuraxial blocks [12] and peripheral nerve blocks [13] leading to prolongation of postoperative analgesia and better pain control
Summary
The concept of pain management has extended from decreasing pain intensity to optimizing patient’s condition. Many procedures were followed to decrease this intense postoperative pain such as, epidural catheter analgesia, Transverse Abdominis Plane (TAP) block, local wound infiltration, Patient-Controlled Analgesia (PCA), peripheral. Dexmedetomidine (DEX) is one of the α adrenoceptor agonists with α2 -adrenoceptor selectivity [11] It has been shown as a valuable additive to local anesthetics in neuraxial blocks [12] and peripheral nerve blocks [13] leading to prolongation of postoperative analgesia and better pain control. Extended midline laparotomy incision is accompanied by intense pain postoperatively which affects patients’ physiology; good control of postoperative pain is mandatory to decrease the adverse effects on the body. Ultrasound-guided Bilateral Rectus Sheath Block (BRSB) is one of the options to achieve this goal
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
