Fentanyl Vs Dexmedetomidine as Adjuvants to Bupivacaine in Erector Spinae Plane Block for Postoperative Analgesia in Patients Undergoing Arthroscopic Shoulder Surgeries

Shoulder arthroscopic surgery is one of the most common surgical procedures performed in daily practice, for many surgical indications as rotator cuff tears, stiffness and instability, this procedure has a well - documented postoperative pain.

The erector spinae plane block (ESPB) is one of the emerging regional techniques for managing postoperative pain. ESPB has been used successfully in many surgeries such as mastectomy, thoracotomies, percutaneous nephrolithotomies, lumbar fusions, hernia repair, cesarean delivery and even in total hip arthroplasty.

Fentanyl as an additive to 0.25% bupivacaine in paravertebral block has been found to reduce the rescue analgesic consumption as well as cumulative pain scores at rest and on movement after breast surgery.

Dexmedetomidine is highly selective than clonidine, specific and potentα2-adrenergic agonist having analgesic, sedative, antihypertensive, and anesthetic sparing effects when used in systemic route.

Inclusion criteria

• Both sexes.
• Age from 21 to 60 years.
• Belonging to American Society of Anesthesiologists (ASA) physical status I and II.
• Underwent shoulder arthroscopic surgery.

Exclusion criteria

• Patients who were known to have an allergy to amide type local anesthetics, dexmedetomidine, or fentanyl.
• Patients who were receiving non-steroidal anti-inflammatory drugs or any chronic drugs for pain management in the past four weeks.
• Had a history of drug dependency or substance addiction.
• Body mass index (BMI) of 18.5 or higher.
• Had a severe spinal deformity.
• Had an uncontrolled concomitant medical condition.
• Had a local skin infection at the injection site or spinal metastasis.