Overview
The aim of the study to Evaluate the efficacy of nalbuphine-bupivacaine vs dexamethasone-bupivacaine in ultrasound guided pericapsular nerve group (PENG) block for improving pain management, reducing opioid consumption, and enhancing the overall analgesic effect in patients undergoing hip surgeries.
Description
- To measure the time of first request of rescue analgesia and to assess the total amount of rescue analgesic consumption (pethidine) in the first 24 hours post-operatively in each group.
- To assess pain score by using numerical rate scale (NRS) at rest (static) and during passive flexion or extension of hip (dynamic).
- To assess the incidence of drug-related side effects (such as nausea, vomiting, bradycardia, hypotension, sedation and hyperglycemia) or block -related side effects (hematoma, infection or LA toxicity) in patients receiving either nalbuphine or dexamethasone as adjuvant to bupivacaine in the PENG block.
- To assess Ease of Spinal Positioning (EOSP).
- To assess patient satisfaction.
Eligibility
Inclusion criteria:
- Patients acceptance.
- Age: Adults aged 21-64 years old.
- BMI: 25-30 kg/m2
- Sex: both sexes (males or females).
- Patients undergoing unilateral hip surgery under spinal anesthesia.
- ASA (American Society of Anesthesiologists) physical status classification I to II.
*Exclusion criteria:
- Patients with contraindications to regional anesthesia (e.g. local or systemic infections, or severe neurological or muscular disorders or patient on anticoagulant).
- Allergy to study drugs: bupivacaine or nalbuphine or dexamethasone
- Patients with severe cardiovascular, respiratory, renal, or hepatic conditions, uncontrolled diabetes diseases, or those undergoing chronic opioid therapy.
- Psychiatric disorders that hinder informed consent or study participation.
- history of neurological diseases or conditions that would affect the efficacy of nerve blocks (e.g., neuropathy, spinal cord injury, or history of severe muscle weakness).