The Effects of Paravertebral Buipivacaine-Dexmedetomidine Versus Bupivacaine-Fentanyl in Unilateral Open Renal Surgeries

Abstract

Study Objective: This trial was designed to test the benefits of adding dexmedetomidine to bupivacaine if compared with the bupivacainefentanyl mixture in paravertebral block for different renal surgeries. Design: Prospective randomized and double-blinded study. Setting: Operative room and postoperative recovery area. Patients: Fifty patients, ASA physical status I and II, aged above 20 years, scheduled for elective open unilateral renal surgeries (nephrectomy, pyelolithotomy and pyeloplasty). Intervention: Patients were randomly allocated by the computer generated list into 2 equal groups (each group had 25patient). Bupivacaine – dexmedetomidine (BD) group received paravertebral bupivacaine 0.2% + dexmedetomidine 1μ/kg for patient below 65 years and 0.5μ/kg for patient above 65 years in a total volume of 20 ml. Bupivacaine fentanyl (BF) group received paravertebral bupivacaine 0.2% + fentanyl 1μ/kg for patient below 65 years and fentanyl 0.5μ/kg for patient above 65 years in a total volume of 20 ml. Measurements: Pain assessed by VAS, heart rate, mean arterial blood pressure, Spo2, postoperative sedation, postoperative adverse effects, total requirement of opioid and first request for analgesia. Main Results: Post-operative visual analogue score and post– operative sedation score were significantly different between both groups in favor of BD group. No satistical difference between both groups as regard HR mean blood pressure and oxygen saturation. No postoperative adverse effects were recorded. Conclusions: The addition of dexmedetomidine to bupivacaine in paravertebral block provides prolonged postoperative analgesia and better sedation score. Also, the addition of dexmedetomidine leads to a reduction in the usage of postoperative opioid.