Intrathecal Versus Intravenous Dexmedetomidine in Prostate Transurethral Resection
The Effect of Intrathecal Versus Intravenous Dexmedetomidine on Postoperative Analgesia in Transurethral Resection of The Prostate
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
Multiple prostatic pathologies become evident in the elderly males. Of them, benign prostatic hyperplasia is one of the most prevalent issues in aging men and transurethral resection of the prostate (TURP) still represents the standard surgical treatment.
Most transurethral resection of the prostate (TURP) procedures are performed under spinal anesthesia. Spinal anesthesia has many advantages including, easy application, low cost, decreasing the risk of aspiration, decreasing intraoperative bleeding, eliminating the need for mechanical ventilation together with the decreased risk of intraoperative cardiac events or post-operative hypoxic episode.
The management of post-operative pain following spinal anesthesia using a short-acting anesthetic still constitutes a major problem for anesthesiologists and pain physicians. However, the duration and efficacy of spinal anesthesia could be improved by adjuvants.
Dexmedetomidine is an alpha 2 receptor agonist that have antinociceptive action for both visceral and somatic pain. At low doses, it has sedative and hypnotic effects without having a negative impact on respiration. Multiple studies have reported that intrathecal and intravenous administration of this drug could prolong the duration of spinal anesthesia and post-operative analgesia.
Studietype
Inschrijving (Verwacht)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Laila Elahwal, MD
- Telefoonnummer: +20 1018484319
- E-mail: Lailaelahwal@gmail.com
Studie Locaties
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ElGharbia
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Tanta, ElGharbia, Egypte, 31511
- Werving
- Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Contact:
- Laila Elahwal, MD
- Telefoonnummer: +20 1018484319
- E-mail: Lailaelahwal@gmail.com
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Cases aged between 50 and 70 years
- Having class I or II according to the American society of anesthesiologists (ASA)
Exclusion Criteria:
- Cases with heart block
- Dysrhythmia
- Contraindications for spinal anesthesia
- Known allergy to the study medications
- Classified as ASA class > II
- Alpha 2 agonist or antagonist therapy.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: Control group
Cases will be subjected to spinal anesthesia with hyperbaric bupivacaine 10 mg.
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The cases will be subjected to spinal anesthesia with a 3 ml volume (2.5 ml of hyperbaric bupivacaine 10 mg in addition to 0.5 normal saline).
50 ml of normal saline was infused over a ten-minute period, followed by 200 ml infusion till the end of operation.
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Experimenteel: Intrathecal group
Cases will be subjected to the same anesthetic mixture as controls with adding dexmedetomidine 5 μg.
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The cases will be subjected to the same anesthetic mixture as controls with adding dexmedetomidine 5 μg in the saline component.
50 ml of normal saline was infused over a ten-minute period, followed by 200 ml infusion till the end of operation.
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Experimenteel: Intravenous group
Cases will receive hyperbaric bupivacaine (10 mg), in addition to IV dexmedetomidine (1 μg/kg loading dose, followed by 0.4 μg/kg/h maintenance dose).
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The intravenous group will receive 2.5 ml of hyperbaric bupivacaine (10 mg), in addition to intravenous dexmedetomidine, which will be started at 1 μg/kg loading dose diluted in 50 ml saline administered within 10 min, followed by maintenance at a 0.4 μg/kg/h dose diluted in 200 ml saline till the end of the procedure.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Time to first analgesic request
Tijdsspanne: 24 hours postoperatively
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Time to first analgesic request will be recorded
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24 hours postoperatively
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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The onset of sensory
Tijdsspanne: 24 hours Postoperatively
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Time to reach T7 sensory block will be recorded
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24 hours Postoperatively
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The degree of motor block
Tijdsspanne: 24 hours Postoperatively
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The degree of motor block will be assessed using the modified Bromage Score.
Grade 0 No motor block Grade 1 Inability to raise extended leg, able to move knees and feet Grade 2 Inability to raise extended leg and move knee, able to move feet Grade 3 Complete motor block of the lower limbs.
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24 hours Postoperatively
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Sedation level
Tijdsspanne: Intraoperativley
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Patients level of sedation will be assessed via Ramsay sedation score.
This score is numbered from 1 to 6, based on patient responsiveness.
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Intraoperativley
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Total analgesic requirements
Tijdsspanne: 48 hours Postoperatively
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Total analgesic requirements will be recorded
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48 hours Postoperatively
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The incidence of side effects
Tijdsspanne: 48 hours Postoperatively
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The incidence of side effects including (bradycardia, hypotension, nausea, vomiting, and pruritis) will be recorded..
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48 hours Postoperatively
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Medewerkers en onderzoekers
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Verwacht)
Studie voltooiing (Verwacht)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Andere studie-ID-nummers
- 34141/9/20
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
IPD-tijdsbestek voor delen
IPD delen Ondersteunend informatietype
- LEERPROTOCOOL
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