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RecruitingNCT07180940Updated Sep 18, 2025

Comparison of Perineural Dexamethasone Versus Dexmedetomidine as Adjuvants to Erector Spinae Plane Block in Lumbar Spine Surgery: A Randomized, Double-blind, Controlled Trial

A Phase 4 interventional study of 0.9%NaCl and Dexamethasone 4mg in Spine Disease and Spinal Diseases, sponsored by Poznan University of Medical Sciences. Recruiting at 1 site in Poland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-09-18.

Sponsored by Poznan University of Medical Sciences · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
150
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This clinical study aims to determine which of two medications-dexamethasone or dexmedetomidine-works better and is safer when used together with a local anesthetic (ropivacaine) in a type of nerve block called the erector spinae plane block (ESPB). This block helps reduce pain after lumbar spine surgery.

Read the detailed description

All participants will receive general anesthesia for surgery and, in addition, a nerve block on both sides of the lower back. The nerve block will be done with ultrasound guidance and will include ropivacaine plus either dexamethasone or dexmedetomidine. Patients will be randomly assigned to one of these two groups, and neither the patient nor the doctors checking pain after surgery will know which medication was used.

The main goal is to see how much opioid pain medicine patients need during the first 24 and 48 hours after surgery. Other things we will look at include how strong the pain is, how soon pain relief is necessary, if there are any side effects like nausea or low blood pressure, and if there are any complications related to the block.

This study will help doctors choose the best option to manage pain after spine surgery while reducing the need for opioids and their side effects.

02

Conditions studied

  • Spine Disease
  • Spinal Diseases

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03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Adults aged 18 to N/A (no limit)
  • Scheduled for elective lumbar spine surgery (e.g., decompression or fusion) via posterior approach
  • American Society of Anesthesiologists (ASA) physical status I-III
  • Body weight ≥ 50 kg
  • Ability to provide written informed consent
  • Expected postoperative hospitalization of at least 48 hours

Exclusion criteria

Exclusion Criteria:

  • Known allergy or contraindication to ropivacaine, dexamethasone, or dexmedetomidine
  • Infection at or near the site of block placement
  • Coagulation disorders or current use of anticoagulant therapy (not discontinued per guidelines)
  • Chronic opioid use or opioid dependence
  • Neurological or psychiatric disorders interfering with pain assessment
  • Diabetes mellitus with poorly controlled glycemia (e.g., HbA1c > 8%)
  • Severe hepatic or renal dysfunction
  • Body mass index (BMI) > 40 kg/m²
  • Pregnancy or breastfeeding
  • Refusal or inability to cooperate with the study protocol
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
150 participants (estimated)

Study arms

  • Placebo comparator
    Control group

    Bilateral ESPB (2 x 20ml 0.2% ropivacaine with 1ml 0.9% NaCl)

    Drug: 0.9%NaCl

  • Experimental
    Dexamethasone group

    Bilateral ESPB (2 x 20ml 0.2% ropivacaine with 2mg dexamethasone)

    Drug: Dexamethasone 4mg

  • Experimental
    Dexmedetomidine group

    Bilateral ESPB (2 x 20ml 0.2% ropivacaine with 25ug dexmedetomidine)

    Drug: Dexmedetomidine

Interventions

  • Drug0.9%NaCl

    2 x 20ml 0.2% ropivacaine with 2ml of 0.9% NaCl

  • DrugDexamethasone 4mg

    2 x 20ml 0.2% ropivacaine with 2mg of dexamethasone

  • DrugDexmedetomidine

    2 x 20ml 0.2% ropivacaine with 25ug Dexmedetomidine

05

What researchers measure

Primary outcomes

  1. Total opioid Consuption

    Cumulative opioid consumption during the first 24 and 48 hours after surgery, converted to morphine milligram equivalents (MME)

    Time frame: 48 hours after surgery

Secondary outcomes

  1. NRS

    Numerical Rating Scale (0 - no pain; 10 - the worst pain ever)

    Time frame: 4 hours after surgery

  2. NRS

    Numerical Rating Scale (0 - no pain; 10 - the worst pain ever)

    Time frame: 8 hours after surgery

  3. NRS

    Numerical Rating Scale (0 - no pain; 10 - the worst pain ever)

    Time frame: 12 hours after surgery

  4. NRS

    Numerical Rating Scale (0 - no pain; 10 - the worst pain ever)

    Time frame: 24 hours after surgery

  5. NRS

    Numerical Rating Scale (0 - no pain; 10 - the worst pain ever)

    Time frame: 48 hours after surgery

  6. Nerve injury

    Nerve damage assesment will be performed using the nerve damage score (N0- no nerve damage; N1- minor - sensory paresthesia; N2- major -complete sensory anesthesia; N3- Complete- complete motor defect with or without paraesthesia; N4-CRPS- Complex Regional Pain Syndrome)

    Time frame: 12 hours after surgery

  7. Nerve injury

    Nerve damage assesment will be performed using the nerve damage score (N0- no nerve damage; N1- minor - sensory paresthesia; N2- major -complete sensory anesthesia; N3- Complete- complete motor defect with or without paraesthesia; N4-CRPS- Complex Regional Pain Syndrome)

    Time frame: 24 hours after surgery

  8. Nerve injury

    Nerve damage assesment will be performed using the nerve damage score (N0- no nerve damage; N1- minor - sensory paresthesia; N2- major -complete sensory anesthesia; N3- Complete- complete motor defect with or without paraesthesia; N4-CRPS- Complex Regional Pain Syndrome)

    Time frame: 48 hours after surgery

  9. adverce effects

    nausea, vomitting, bradycardia, hypotension

    Time frame: 48 hours after surgery

  10. Time to first rescue analgesia

    Time after surgery when the patient needs rescue analgesia for the first time

    Time frame: 48 hours after surgery

  11. blood glucose

    Blood glucose concentration measured postoperatively

    Time frame: 12 hours after surgery

  12. blood glucose

    Blood glucose concentration measured postoperatively

    Time frame: 24 hours after surgery

  13. blood glucose

    Blood glucose concentration measured postoperatively

    Time frame: 48 hours after surgery

  14. NLR - Neutrophil-to-Lymphocyte Ratio

    NLR will be calculated from complete blood count results

    Time frame: 12 hours after surgery

  15. NLR - Neutrophil-to-Lymphocyte Ratio

    NLR will be calculated from complete blood count results

    Time frame: 24 hours after surgery

  16. NLR - Neutrophil-to-Lymphocyte Ratio

    NLR will be calculated from complete blood count results

    Time frame: 48 hours after surgery

  17. PLR - Platelet-to-Lymphocyte Ratio

    PLR will be calculated from complete blood count results

    Time frame: 12 hours after surgery

  18. PLR - Platelet-to-Lymphocyte Ratio

    PLR will be calculated from complete blood count results

    Time frame: 24 hours after surgery

  19. PLR - Platelet-to-Lymphocyte Ratio

    PLR will be calculated from complete blood count results

    Time frame: 48 hours after surgery

06

Study locations

1 of 1 sites recruiting
  • Poznan University of Medical Sciences
    Poznan, 62-701, Poland
    Recruiting
07

References and documents

Individual participant data

Plan to share: Yes

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07180940
Lead sponsor
Poznan University of Medical Sciences
Responsible party
Sponsor
First posted
Sep 18, 2025
Start date
Sep 1, 2025
Primary completion
Sep 30, 2026 (estimated)
Completion
Dec 31, 2026 (estimated)
Last update
Sep 18, 2025

Study contacts

Malgorzata Reysner, M.D. Ph.D.
Contact
mreysner@ump.edu.pl
+48 61 873 83 03

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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