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

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.

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Key information

Conditions

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

Age range

18 year–60 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

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

Exclusion criteria

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.

Treatment and study plan

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traversing through trapezius, rhomboid, and erector spinae muscles till reaching the transverse process then slightly withdrawn and hydrodissection was done by 3 mL of saline 0.9% to verify the accurate implantation of the block needle tip between the erector spinae muscle and the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.

Primary outcomes

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

Time frame: 24 hours postoperatively

Secondary outcomes

.Total ketorolac consumption

Time frame: 24 hours postoperatively
. Number of patients needed rescue tramadol

Time frame: 24 hours postoperatively

Study contacts

Contact information is provided by the study sponsor or research team.

Ramy Mahrose

CONTACT

[email protected]

01281431097

Sponsors and collaborators

Lead sponsor

Ain Shams University

Other

Registry information

Important dates

Study start: 2026
Primary completion: 2026
Study completion: 2026
First posted: Feb 20, 2026
Registry last updated: Feb 20, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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