Comparison of Dexamethasone and Dexmedetomidine as an Adjuvant to 0.375% Ropivacaine in Erector Spinae Plane Block for Lumbar Spine Surgery: A Randomized, Double-Blind, Placebo-Control Trial.

Erector Spinae Plane Block for Lumbar Spine Surgery

Abstract

Background: Erector spinae plane block (ESPB) is an interfascial plane block that successfully deposits a local anesthetic deep into the erector spinae muscle that lies adjacent to transverse processes. The present study was conducted to assess the effect of dexmedetomidine and dexamethasone as an adjuvant for the erector spinae plane block (ESPB) to control postoperative pain after lumbar spine surgery. Subjects & Methods: 60 patients selected for undergoing lumbar spine surgery were divided into 3 groups of 20 each. Group, I patients received 0.375% ropivacaine 20 mL group II patients received 0.375% ropivacaine 20 mL with 8 mg dexamethasone and group III patients received 0.375% ropivacaine 20 mL with 1 g/kg dexmedetomidine deep to the erector spinae muscle. Postoperative tramadol consumption, amount of rescue analgesia use, post-surgical hospital stay and postoperative nausea and vomiting (PONV) were recorded. Results: The demographic data and intraoperative opioid requirements were comparable in all groups. Postoperative tramadol consumption and rescue analgesic requirement were significantly less in group III as compared to group II and I. Postoperative stay in hospital was 6.1 days in 6.2 days in group II and 4.6 days     in group III and the difference was significant. Conclusion: Dexmedetomidine is found to be better than dexamethasone as an adjuvant to ropivacaine in erector spinae plane block in lumbar spine surgery.