Efficacy of Dexmedetomidine as an Adjuvant in Obturator Nerve Block for Postoperative Pain in Patients Undergoing Transurethral Surgeries Under Spinal Anesthesia

Document Type : Original Article

Abstract

Background:Bladder cancer is the second most common genitourinary cancer. The standard treatment for superficial bladder tumors is intravesical transurethral resection. Obturator nerve block (ONB) enhances analgesia quality in bladder surgeries. Dexmedetomidine (DEX) can extend the duration of sensory and motor nerve blocks.
Aim: To evaluate the effect of adding DEX to a local anesthetic on the efficacy of ONB in reducing postoperative pain compared to ONB with a local anesthetic alone.
Patients and Methods: This randomized study was carried out on 56 cases scheduled for transurethral surgery. They were randomly divided into two groups: Group A (n=28) received regional anesthesia and bilateral ONB with DEX (2 µg/kg), while Group B (n=28) received regional anesthesia and bilateral ONB only. Pain was assessed using a visual analogue scale (VAS) at various intervals up to 24 hours postoperatively. Additionally, time to first analgesic request, total analgesic consumption in 24 hours, sensory and motor block duration, adverse effects, and incidence of the adductor reflex were recorded.
Results: Group A had significantly lower VAS scores at 6, 8, and 12 hours postoperatively (P-values =0.045, 0.041, 0.030, respectively). Sensory and motor block duration was longer in Group A (P-value =0.01), with a delayed time to first analgesic request (P-value <0.001) and reduced nalbuphine use in 24 hours (P-value <0.001).
Conclusion: Adding DEX to a local anesthetic in ONB improves postoperative pain management, resulting in lower pain scores, reduced analgesic requirements, and extended analgesic duration.
 

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The Egyptian Journal of Hospital Medicine
Volume 98, Issue 1
January 2025
Pages 36-43

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