Addition of Dexmedetomidine to Ropivacaine in Bilateral Erector Spinae Plane Block in Patients Undergoing Coronary Artery Bypass Surgery

Launched by LEBANESE AMERICAN UNIVERSITY · May 17, 2025

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ClinConnect Summary

This clinical trial is studying whether adding a medication called dexmedetomidine to a local anesthetic called ropivacaine can help manage pain better after coronary artery bypass surgery (CABG). The goal is to improve pain relief while reducing the need for opioid medications, which can have unwanted side effects. In this study, 110 adult patients scheduled for elective CABG surgery will be randomly divided into two groups: one will receive ropivacaine alone, and the other will receive ropivacaine with dexmedetomidine. The researchers will measure how long patients can manage their pain effectively before needing opioids and will also look at other factors such as pain levels, recovery times, and any side effects.

To be eligible for this trial, participants need to be between 25 and 80 years old, be planned for elective off-pump CABG surgery, and have no cognitive impairments. They should also meet certain health criteria, such as having a heart function considered adequate. Participants will receive a nerve block before surgery to help with pain control. The study aims to find a way to improve pain management for heart surgery patients while addressing the issues related to opioid use.

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Eligibility criteria

• Inclusion Criteria:
• • 1. Age range: 25 - 80 years old
• • 2. Planned for elective OFF PUMP CABG
• • 3. Cognitively not impaired
• • 4. American Society of Anesthesiologists class 3
• • 5. Left ventricular ejection fraction ≥40%
• • 6. Consent form for the study signed
• • 7. No infection at the site of injection
• • 8. No contraindication for ESP block (thrombocytopenia, anticoagulation therapy)
• • 9. No documented allergy to ropivacaine or dexmedetomidine
• Exclusion Criteria:
• • 1. Refusal to participate in the study
• • 2. Emergency surgery
• • 3. American Society of Anesthesiologists class \>3
• • 4. Left ventricular ejection fraction \<40%
• • 5. Infection at the site of injection for ultrasound-guided ESPB
• • 6. Coagulation disorders
• • 7. Documented allergy to ropivacaine or dexmedetomidine
• • 8. Greater than first-degree heart block
• • 9. Bradycardia (heart rate \[HR\] \< 50 bpm)
• • 10. Pregnancy
• • 11. BMI ≥40
• • 12. Psychiatric illnesses that would interfere with the assessment of pain scores
• • 13. History of alcohol or drug abuse and chronic analgesic use