Opioid-sparing Effect of Erector Spinae Plane Block and Intravenous Dexmedetomidine for Obese Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial
Objective:
This study aimed to evaluate the impact of erector spinae plane block (ESPB) and intravenous (IV) dexmedetomidine in reducing opioid consumption after bariatric surgery and their effects on post-operative recovery, pain relief, and lung functions.
Design:
A randomized controlled trial.
Location:
Tanta University Hospitals, Tanta, Gharboa, Egypt.
Participants:
Forty obese patients with obstructive sleep apnea syndrome (OSAS), aged 20-55 years, eligible for bariatric surgery.
Interventions:
Patients were assigned to group I (received general anesthesia with opioid, sham ESPB, and IV normal saline) or group II (received general anesthesia without opioid, ESPB at T7 level using 20 mL bupivacaine 0.25%, and bolus IV dexmedetomidine 1 µg/kg followed by 0.25 µg/kg/h).
Main Outcome Measures:
Recorded outcomes included perioperative fentanyl consumption (primary outcome), sevoflurane consumption, recovery time, Visual Analog Scale (VAS) scores, and pulmonary functions.
Results:
Group II showed significantly lower perioperative fentanyl and sevoflurane consumption compared to group I (p = 0.010, <0.001, <0.001, and <0.001, respectively). Group II also had shorter recovery time (p < 0.001) and lower VAS scores at various post-operative time points. Postoperative pulmonary function did not significantly change, but oxygen desaturation was significantly lower in group II (p = 0.001).
Conclusions:
ESPB with IV dexmedetomidine benefits OSAS patients undergoing bariatric surgery by reducing opioid use, shortening recovery time, providing adequate pain relief, and minimizing complications. However, it did not significantly affect post-operative pulmonary function.
PMID:
39017616
DOI:
10.5055/jom.0873
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