Spinal Anesthesia AdministrationNCT07114263
Study of The Analgesic Profile of Two Adjuvants Added to Low Dose Hyperbaric Bupivacaine Versus One Adjuvant in Patients Undergoing Anal Surgery Using Spinal Anesthesia
A study testing Group F (fentanyl group), Group D :Dexmedetomidine group and Group DF :Fentanyl and Dexmedetomidine group in people with Spinal Anesthesia Administration and Analgesic, run by Tanta University at 1 site in Egypt.
Trial summary
This study will be conducted to compare the efficacy of fentanyl and Dexmedetomidine as an additive to hyperbaric bupivacaine 0.5% in saddle block anesthesia on duration of analgesia in patients undergoing anorectal surgeries. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Spinal Anesthesia Administration, Analgesic, Anorectal Surgery
- What is being tested?
- Group F (fentanyl group), Group D :Dexmedetomidine group and Group DF :Fentanyl and Dexmedetomidine group
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteEgypt
- Study dates
- Aug 2025to Feb 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- aged from 18 to 65 years
- American Society of Anesthesiologists' physical I or II of both sexes
- Patients who will be scheduled to surgery for their uncomplicated hemorrhoids, anal fissure, or anal fistula in lithotomy position will be included in the study.
Who cannot join
- Infection focus at back, history of spine surgery, coagulopathy, mental disturbance, and neurological disease.
- drug allergy.
- intake of experimental or analgesic medication within last 24 hours.
- patients receiving alpha-adrenergic antagonist will be excluded from the study.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt1 site
Tanta University
Tanta, Gharbia Governorate
Ezzat Alhelw, Resident, +20 10 06489620, ezzatnasr136@gmail.com
About this study
Official title: Study of The Analgesic Profile of Two Adjuvants Added to Low Dose Hyperbaric Bupivacaine Versus One Adjuvant in Patients Undergoing Anal Surgery Using Spinal Anesthesia ( Saddle Block ): A Randomized Prospective Study
This study will be conducted to compare the efficacy of fentanyl and Dexmedetomidine as an additive to hyperbaric bupivacaine 0.5% in saddle block anesthesia on duration of analgesia in patients undergoing anorectal surgeries.
Read the detailed description
Pilonidal sinus, hemorrhoidectomy, anal fistula or fissure repair are the main types of anorectal surgery. Various surgical and anesthetic techniques have been introduced to improve analgesia level and limit the motor blockade.Regional anesthesia is preferred for anorectal surgeries to avoid the risks of general anesthesia. Besides, providing effective post-operative analgesia, regional techniques reduce the opioid use.
Intrathecal administration of drugs to obtain anesthesia has been in use since the turn of the twelfth century. Saddle block anesthesia is a kind of low spinal block that provides anesthesia over the saddle area, i.e., perineum, perianal area, medial aspect of legs and thigh.
Saddle block anesthesia is performed by injecting a small dose of hyperbaric local anaesthetic at the level of L3, L4 after which the patient is maintained in sitting position for a few minutes to facilitate preferential impregnation of sacred roots (S1 to S5), which is responsible for innervation of perineum, external genitalia and anus. The saddle block causes a parasympathetic blockade at the bladder level which may result in bladder and rectal atony which is advantageous because of sphincteric relaxation needed for the operation.
Hyperbaric bupivacaine 0.5% is the most common local anaesthetic used for spinal anaesthesia for lower abdominal and lower limb surgeries. One disadvantage with using hyperbaric bupivacaine alone is a relatively shorter duration of action that means that early analgesic intervention is needed in postoperative period. Adjuvants are drugs that increase the efficacy or potency of other drugs when given concurrently. Neuraxial adjuvants are used to increase the speed of the onset of neural blockade (reduce latency), improve the quality and prolong the duration of neural blockade.
Fentanyl is a lipophilic short-acting opioid that exhibits close structural similarities to local anesthesia and has demonstrable local anesthetic efficacy on sensory C primary afferent nerve fibers, which may facilitate analgesic effects. It has improved spinal anesthesia and reduced the anesthetic drug related side effects including pruritus, nausea and vomiting.
Dexmedetomidine, a highly selective alpha_2 agonist, is being introduced as an adjuvant to local anesthetics with significant analgesic, sympatholytic, and sedative properties. Compared to clonidine; Dexmedetomidine is approximately eight times more selective towards α2-adrenergic receptors , which is associated with sedative and analgesic effects in supraspinal and spinal sites and also has an antinociceptive impact on both visceral and somatic pain.
This study will be conducted to compare the efficacy of fentanyl and Dexmedetomidine as an additive to hyperbaric bupivacaine 0.5% in saddle block anesthesia on duration of analgesia in patients undergoing anorectal surgeries.
- Being tested
- Group F (fentanyl group), Group D :Dexmedetomidine group, Group DF :Fentanyl and Dexmedetomidine group
- Keywords
- anorectal surgeries., hyperbaric bupivacaine, Dexmedetomidine, Spinal Anesthesia, Saddle Block
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Group F (fentanyl group)Drug
Group F (fentanyl group):will receive intrathecal 1.5 ml hyperbaric bupivacaine 0.5% and 0.5 ml (25 mcg) Fentanyl and 1 ml glucose 5% with total volume of 3ml.
Group D :Dexmedetomidine groupDrug
Group D :Dexmedetomidine group: will receive intrathecal 1.5 ml hyperbaric bupivacaine 0.5% and 1 ml (4 mcg) Dexmedetomidine and 0.5 ml glucose 5% with total volume of 3ml.
Group DF :Fentanyl and Dexmedetomidine groupDrug
Fentanyl and Dexmedetomidine group:will receive intrathecal 1.5 ml hyperbaric bupivacaine 0.5%, 0.5 ml (25 mcg) Fentanyl and 1 ml (4 mcg) Dexmedetomidine with total volume of 3ml.
| Study group | Role | What they receive |
|---|---|---|
| Group F :Fentanyl group | Experimental | Patients will receive intrathecal 1.5 ml hyperbaric bupivacaine 0.5% and 0.5 ml (25 mcg) Fentanyl and 1 ml glucose 5% with total volume of 3ml. Receives: Drug: Group F (fentanyl group) |
| Group D: Dexmedetomidine group | Experimental | Patients will receive intrathecal 1.5 ml hyperbaric bupivacaine 0.5% and 1 ml (4 mcg) Dexmedetomidine and 0.5 ml glucose 5% with total volume of 3ml. Receives: Drug: Group D :Dexmedetomidine group |
| Group DF :Fentanyl and Dexmedetomidine | Experimental | Patients will receive intrathecal 1.5 ml hyperbaric bupivacaine 0.5%, 0.5 ml (25 mcg) Fentanyl and 1 ml (4 mcg) Dexmedetomidine with total volume of 3ml. Receives: Drug: Group DF :Fentanyl and Dexmedetomidine group |
What is being measured
The primary outcome is the main question the study is designed to answer.
Duration of analgesia
from time of spinal block to first demand of rescue analgesia
Measured: 2 hours
Secondary outcomes (1)
Incidence of complications
- Incidence of complications e.g., Hypotension, Bradycardia, nausea/vomiting, urinary retention, pruritus, and shivering.
Measured: 24 hours
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Aug 2025
- Study startAug 2025 (estimated)
- Primary completionFeb 2026 (estimated)
- Study completionFeb 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Spinal Anesthesia AdministrationStudies of the same condition, open and under way.
- More trials run by Tanta UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Tanta University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Ezzat Nasr Ezzat Alhelw, Tanta University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07114263
- Sponsor's protocol ID
- 36264MS785/12/24
- Status last verified
- Feb 2025
- First submitted
- 4 Aug 2025
- Last updated
- 11 Aug 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 11 Aug 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Study of The Analgesic Profile of Two Adjuvants Added to Low Dose Hyperbaric Bupivacaine Versus One Adjuvant in Patients Undergoing Anal Surgery Using Spinal Anesthesia ( Saddle Block ): A Randomized Prospective Study
- ClinicalTrials.gov ID
- NCT07114263
- Acronym / sponsor ID
- 36264MS785/12/24
- Keywords
- anorectal surgeries., hyperbaric bupivacaine, Dexmedetomidine, Spinal Anesthesia, Saddle Block
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Tanta UniversityUniversity, hospital or other
- Study start
- Aug 2025 (estimated)
- Primary completion
- Feb 2026 (estimated)
- Study completion
- Feb 2026 (estimated)
- First posted
- 11 Aug 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will be conducted to compare the efficacy of fentanyl and Dexmedetomidine as an additive to hyperbaric bupivacaine 0.5% in saddle block anesthesia on duration of analgesia in patients undergoing anorectal surgeries.
Detailed description
Pilonidal sinus, hemorrhoidectomy, anal fistula or fissure repair are the main types of anorectal surgery. Various surgical and anesthetic techniques have been introduced to improve analgesia level and limit the motor blockade.Regional anesthesia is preferred for anorectal surgeries to avoid the risks of general anesthesia. Besides, providing effective post-operative analgesia, regional techniques reduce the opioid use.
Intrathecal administration of drugs to obtain anesthesia has been in use since the turn of the twelfth century. Saddle block anesthesia is a kind of low spinal block that provides anesthesia over the saddle area, i.e., perineum, perianal area, medial aspect of legs and thigh.
Saddle block anesthesia is performed by injecting a small dose of hyperbaric local anaesthetic at the level of L3, L4 after which the patient is maintained in sitting position for a few minutes to facilitate preferential impregnation of sacred roots (S1 to S5), which is responsible for innervation of perineum, external genitalia and anus. The saddle block causes a parasympathetic blockade at the bladder level which may result in bladder and rectal atony which is advantageous because of sphincteric relaxation needed for the operation.
Hyperbaric bupivacaine 0.5% is the most common local anaesthetic used for spinal anaesthesia for lower abdominal and lower limb surgeries. One disadvantage with using hyperbaric bupivacaine alone is a relatively shorter duration of action that means that early analgesic intervention is needed in postoperative period. Adjuvants are drugs that increase the efficacy or potency of other drugs when given concurrently. Neuraxial adjuvants are used to increase the speed of the onset of neural blockade (reduce latency), improve the quality and prolong the duration of neural blockade.
Fentanyl is a lipophilic short-acting opioid that exhibits close structural similarities to local anesthesia and has demonstrable local anesthetic efficacy on sensory C primary afferent nerve fibers, which may facilitate analgesic effects. It has improved spinal anesthesia and reduced the anesthetic drug related side effects including pruritus, nausea and vomiting.
Dexmedetomidine, a highly selective alpha_2 agonist, is being introduced as an adjuvant to local anesthetics with significant analgesic, sympatholytic, and sedative properties. Compared to clonidine; Dexmedetomidine is approximately eight times more selective towards α2-adrenergic receptors , which is associated with sedative and analgesic effects in supraspinal and spinal sites and also has an antinociceptive impact on both visceral and somatic pain.
This study will be conducted to compare the efficacy of fentanyl and Dexmedetomidine as an additive to hyperbaric bupivacaine 0.5% in saddle block anesthesia on duration of analgesia in patients undergoing anorectal surgeries.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Group F :Fentanyl group | Experimental | Drug: Group F (fentanyl group)Patients will receive intrathecal 1.5 ml hyperbaric bupivacaine 0.5% and 0.5 ml (25 mcg) Fentanyl and 1 ml glucose 5% with total volume of 3ml. |
| Group D: Dexmedetomidine group | Experimental | Drug: Group D :Dexmedetomidine groupPatients will receive intrathecal 1.5 ml hyperbaric bupivacaine 0.5% and 1 ml (4 mcg) Dexmedetomidine and 0.5 ml glucose 5% with total volume of 3ml. |
| Group DF :Fentanyl and Dexmedetomidine | Experimental | Drug: Group DF :Fentanyl and Dexmedetomidine groupPatients will receive intrathecal 1.5 ml hyperbaric bupivacaine 0.5%, 0.5 ml (25 mcg) Fentanyl and 1 ml (4 mcg) Dexmedetomidine with total volume of 3ml. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- aged from 18 to 65 years
- American Society of Anesthesiologists' physical I or II of both sexes
- Patients who will be scheduled to surgery for their uncomplicated hemorrhoids, anal fissure, or anal fistula in lithotomy position will be included in the study.
Key exclusion criteria (4 listed)
- Infection focus at back, history of spine surgery, coagulopathy, mental disturbance, and neurological disease.
- drug allergy.
- intake of experimental or analgesic medication within last 24 hours.
- patients receiving alpha-adrenergic antagonist will be excluded from the study.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Group F (fentanyl group)Group F (fentanyl group):will receive intrathecal 1.5 ml hyperbaric bupivacaine 0.5% and 0.5 ml (25 mcg) Fentanyl and 1 ml glucose 5% with total volume of 3ml. | Drug | Group F :Fentanyl group |
| Group D :Dexmedetomidine groupGroup D :Dexmedetomidine group: will receive intrathecal 1.5 ml hyperbaric bupivacaine 0.5% and 1 ml (4 mcg) Dexmedetomidine and 0.5 ml glucose 5% with total volume of 3ml. | Drug | Group D: Dexmedetomidine group |
| Group DF :Fentanyl and Dexmedetomidine groupFentanyl and Dexmedetomidine group:will receive intrathecal 1.5 ml hyperbaric bupivacaine 0.5%, 0.5 ml (25 mcg) Fentanyl and 1 ml (4 mcg) Dexmedetomidine with total volume of 3ml. | Drug | Group DF :Fentanyl and Dexmedetomidine |
Primary outcome
Duration of analgesia
Time frame: 2 hours
from time of spinal block to first demand of rescue analgesia
1 secondary outcome
Incidence of complications
Time frame: 24 hours
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Aug 2025.
- Individual participant dataSharing planned: Yes
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Group F (fentanyl group), Group D :Dexmedetomidine group and Group DF :Fentanyl and Dexmedetomidine group in people with Spinal Anesthesia Administration and Analgesic, run by Tanta University at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 11 Aug 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Ezzat Alhelw, Resident (+20 10 06489620, ezzatnasr136@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Duration of analgesia (time frame: 2 hours). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Aug 2025.