A comparative study of plain ropivacaine and ropivacaine with dexmedetomidine as an additive for ultrasound-guided erector spinae plane block in spine surgeries for postoperative analgesia

Abstract Background: To improve the block outcomes, an adjunct such as dexmedetomidine (DEX) has been added to local anesthetics (LAs). DEX improves anesthesia and analgesia when mixed with LAs. The search for the most beneficial adjuvant with minimal side effects continues. Objective: To assess the effectiveness of DEX combined with ropivacaine in ultrasound-guided erector spinae plane block (ESPB) in spine surgeries. Methods: This was a hospital-based, prospective–comparative study carried out among 60 subjects. They were divided into two groups: Group A ( n = 30) received 60 ml of 0.2% ropivacaine and Group B ( n = 30) received 60 ml of 0.2% ropivacaine with 1 μg/kg of DEX in ultrasound-guided ESPB. Age, sex, American Society of Anesthesiologists (ASA) grades, body mass index, onset and duration of blockade, hemodynamic parameters, and time to administration of first rescue analgesic was compared in the two groups. Results: Both the groups were comparable for baseline characteristics such as age, sex, ASA grades, body mass index, and duration of surgery ( P > 0.05). The onset of blockade was similar in the two groups ( P > 0.05). The duration of blockade was significantly more in Group B patients compared to Group A patients ( P < 0.05). All hemodynamic parameters at all time intervals were comparable in the two groups ( P > 0.05). Time to the administration of first rescue analgesic (in hours) was significantly more in those who received ropivacaine with DEX than in those who received only plain ropivacaine ( P < 0.05). Conclusion: Addition of DEX prolongs the duration of analgesia, potentially reducing the need for postoperative opioids and improving patient comfort compared to 0.2% ropivacaine alone in ultrasound-guided ESPB.