Effect of Dexmedetomidine Versus Dexamethasone as Adjuvant to Bupivacaine in Ultrasound Guided Erector Spinae Plane Block on Postoperative Analgesia in Myasthenic Patients Undergoing Thoracoscopic Thymectomy

NCT07424599 | Not Yet Recruiting

• 1 other identifier: HRM 3
• Study Type: interventional
• Target: 60
• Locations: 0 countries
• Sites: N/A

Brief Summary

This current comparative study involved 54 patients undergoing thoracoscopic thymectomy who were distributed randomly into three equal groups to receive ultrasound (US)-guided ESPB using 20 ml bupivacaine 0.25% (group B) , 20 ml bupivacaine 0.25% with 8 mg dexamethasone (group BS), 20 ml bupivacaine 0.25% with dexmedetomidine 1mcg/kg (group BM). The time till the first postoperative rescue analgesic requested was the primary outcome. The secondary outcomes included the postoperative pain scores and analgesic consumption.

Conditions

Postoperative Pain, Acute

Outcome Measures

Primary Outcomes (1)

• the duration between the surgery end and the 1st rescue analgesia the patient requested.

  24 hours postoperatively

Secondary Outcomes (2)

• .Total ketorolac consumption

  24 hours postoperatively

• . Number of patients needed rescue tramadol

  24 hours postoperatively

Study Arms (3)

(group B)

ACTIVE COMPARATOR

ultrasound (US)-guided ESPB using 20 ml bupivacaine 0.25%

Procedure: Erector Spinae Plane Block

Group BS

ACTIVE COMPARATOR

20 ml bupivacaine 0.25% with 8 mg dexamethasone

Procedure: Erector Spinae Plane Block

Group BM

ACTIVE COMPARATOR

20 ml bupivacaine 0.25% with dexmedetomidine 1mcg/kg

Procedure: Erector Spinae Plane Block

Interventions

Erector Spinae Plane Block PROCEDURE

An echogenic 21 gauge 10 cm needle was introduced in caudo-cephalic orientation utilizing the in-plane approach and traversing through trapezius, rhomboid, and erector spinae muscles till reaching the transverse process then slightly withdrawn and hydrodissection was done by 3 mL of saline 0.9% to verify the accurate implantation of the block needle tip between the erector spinae muscle and the transverse process (the erector spinae plane). Incremental LA injection was verified through US observation for the upward displacement and lifting of erector spinae muscle from the transverse process with craniocaudal spread of the LA in the targeted plane. The LA increments were one ml every 5 seconds with intermittent aspiration every 5 mL to avoid intravascular injection.

(group B)

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• myasthenic patients
• American Society of Anesthesiologists (ASA) physical grade of 2-3)
• who underwent video assisted thoracoscopic thymectomy

You may not qualify if:

• Refused participation in the study,
• known allergy for this study drugs ,
• Contraindication to the ESPB as infection at block site \& marked chest cage deformity,
• significant bleeding disorders ,
• patients with significant renal or liver dysfunction,
• heart block ,
• poor ventilatory function,
• severe chronic obstructive pulmonary disease,
• morbid obesity,
• mental disability, or communication difficulties that hindered effective pain assessment,
• Individuals who was converted to open thoracotomy or those re-explorated for surgical related issues.

Sponsors & Collaborators

• Ain Shams University: lead

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Central Study Contacts

Ramy Mahrose

CONTACT

01281431097; Ramy.ahmed@med.asu.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assisstant professor of anesthesia,intensive care and pain management

Study Record Dates

• First Submitted: February 15, 2026
• First Posted: February 20, 2026
• Study Start: March 15, 2026
• Primary Completion (Estimated): September 15, 2026
• Study Completion (Estimated): September 15, 2026
• Last Updated: February 20, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share