Comparative Study Between Dexmedetomidine with Bupivacaine and Bupivacaine Alone in Erector Spinae Plane Block for Postoperative Pain Control of Posterior Lumbosacral Spine Fixation Surgeries: A Randomized Controlled Trial

Figures & data

Figure 1 Ultrasound image of ESPB.

Table 1 Sociodemographic Data of the Studied Groups

		DB group	B group	S group	Test of Significance	P-value
Sex	Male	19(63.3%)	22(73.3%)	21(70%)	χ^2=0.73	0.696
	Female	11(36.7%)	8(26.7%)	9(30%)
Age		44.27±13.26	44.6±12.32	44.73±12.41	F=0.011	0.99
Weight		98.67±10.13	98.63±9.19	99.6±9.32	F=0.99	0.91
ASA score	I	11(36.7%)	15(50%)	13(43.3%)	χ^2= 1.2	0.88
	II	16(53.3%)	13(43.3%)	14(46.7%)
	II	3(10%)	2(6.7%)	3(10%)

Figure 2 Flow diagram of patient’s enrollment.

Figure 3 Passive VAS score (VAS>6) 1st 24 hour. *Statistical significance difference between DB and S group. **High Statistical significance difference between DB and S group. ***Statistical significance difference between DB and B group. ****High Statistical significance difference between DB and B group.

Figure 4 Active VAS score (VAS>6) in 1st 24 hours. *High Statistical significance difference between DB and S group. **High Statistical significance difference between DB and B group. ***Statistical significance difference between DB and B group.

Figure 5 Passive VAS score (VAS>6) in 2nd 24 hour. *High Statistical significance difference between DB and S group. **High Statistical significance difference between DB and B group. ***Statistical significance difference between DB and B group.

Figure 6 Active VAS score (VAS>6) in 2nd 24 hour. *High Statistical significance difference between DB and S group. **High Statistical significance difference between DB and B group. ***Statistical significance difference between DB and B group. ****Statistical significance difference between DB and S group.

Table 2 Rescue Analgesia in 1^st and 2^nd 24 Hours

	DB group	B group	S group	P-value
Rescue analgesia in 1st 24 hours (number of times for each patient)	0.0±0.0	0.33±0.61^a.	0.9±1.2^b.	0.001**
Rescue analgesia in 2nd 24 hours (number of times for each patient)	0.23±0.43	0.87±0.94^a.	0.9±1.29^b.	0.012*

Notes: ^aHigh Statistical significance difference between DB and B group in 1st and 2nd 24 hours (p value= 0.003 and 0.006) respectively. ^bHigh Statistical significance difference between DB and S group in 1st 24 hours (P-value=0.00) and Statistical significance difference between DB and S group in 2nd hour (p-value = 0.01). *Statistical significance difference between the three groups. **High Statistical significance difference between the three groups.

Table 3 Total Postoperative Opioid Consumption (Number of PCA Presses)

	DB group	B group	S group	P-value
Number of PCA presses in 1st 24 h	0	18±7.76^a.	54.5±17.39^b.	<0.001**
Number of PCA presses in 2nd 24 h	16.87±5.53	40.17±10.63^a	41.67±9.86^b.	<0.001**

Notes: ^aHigh Statistical significance difference between DB and B group (P-value = 0.00) LSD. ^bHigh Statistical significance difference between DB and S group (P-value = 0.00) LSD. **High Statistical significance difference between the three groups.

Table 4 Intraoperative and Postoperative Complications

		DB group	B group	S group	χ ^2	P-value
Intraoperative Complications	Bradycardia	2(6.7%)	1(3.3%)	2(6.7%)	1.14	0.887
	Hypotension	3(10%)	4(13.3%)	2(6.7%)	0.46	0.794
Postoperative Complications	Nausea	0	7(23.3%) ^a.	14(46.7%)^b.	18.26	<0.001**
	Vomiting	0	7(23.3%) ^a.	9(30%)^b.	10.19	0.006**
	Pruritis	0	6(20%) ^a.	7(23.3%)^b.	11.71	0.003**

Notes: ^aHigh Statistical significance difference between DB and B group regarding Nausea, vomiting and pruritus (P- value= 0.001, 0.001 and 0.003) respectively. ^bHigh Statistical significance difference between DB and S group regarding Nausea, vomiting and pruritus (P- value< 0.001, <0.001 and <0.001) respectively. **High Statistical significance difference between the three groups.

Table 5 Regression Analysis Between Primary Outcomes and Studied Groups (S, B, DB)

Outcomes (Reference: S Group)	B Group	DB Group
Active VAS 1st 24 hours*	P-value: 0.79, OR: 1.15; 95% CI: 0.40–3.26	–
Active VAS 2nd 24 hours*	P-value: 0.78, OR: 0.86; 95% CI: 0.29–2.49	P-value: 0.78, OR: 0.86; 95% CI: 0.29–2.49
Passive VAS 1st 24 hours*	P-value: 0.57, OR: 0.72; 95% CI: 0.24–2.20	–
Passive VAS 2nd 24 hours*	P-value: 0.79, OR: 0.86; 95% CI: 0.30–2.46	P-value: 0.09, OR: 0.37; 95% CI: 0.11–1.19
Number of PCA presses in 1st 24 h°	S Coefficients B: −0.17, P-value:0.10; 95% CI: 20.36- (−1.86)	S Coefficients B: −0.680, P-value:0.00; 95% CI: -44.52-(−27.97)**
Number of PCA presses in 2nd 24 h°	S Coefficients B: 0.35, P-value: 0.001; 95% CI:4.87–16.93**	S Coefficients B: −0.789, P-value:0.00; 95% CI: -28.01-(−20.08)**
Rescue analgesia in 1st 24 hours (number of times for each patient) °	S Coefficients B: −0.06, P-value: 0.56; 95% CI: −0.51–0.28	S Coefficients B: −0.325, P-value: 0.002; 95% CI: −0.99-(−0.23)**
Rescue analgesia in 2nd 24 hours (number of times for each patient)°	S Coefficients B: 0.16, P-value:0.13; 95% CI: −0.09–0.69	S Coefficients B: −0.34, P-value: 0.001; 95% CI: −1.02-(−0.278)**

Notes: *Binary logistic regression: Studying the association between categorical VAS variable (6≤, 6># the event#) (dependent variable) and intervention drug groups (S: Reference, D, DB) (independent variable). °Linear regression: Studying the association between number of PCA presses, rescue analgesia variables (numeric dependent variables) and intervention drug groups (Dummy variables: D, DB) (independent variable). **High Statistical significance difference.