الفهرس 
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Abstract
This research paper investigates the preemptive analgesic effects of the ultrasound-guided caudal epidural block using plain bupivacaine versus dexamethasone as an adjuvant in patients undergoing lumbar spine decompression and fusion surgery. Postoperative pain management remains a significant concern in complex procedures like lumbar spine decompression and fusion. Effective pain control not only enhances patient comfort and satisfaction but also contributes to faster recovery and reduced hospital stays.
The study’s primary objective is to compare the analgesic efficacy of two different approaches for caudal epidural block administration: one utilizing plain bupivacaine and the other incorporating dexamethasone as an adjuvant reflected in terms of postoperative morphine consumption. The preemptive nature of the intervention aims to mitigate pain perception by targeting nociceptive pathways before surgery-induced tissue damage occurs. The use of ultrasound guidance enhances the accuracy and safety of the caudal epidural block, ensuring precise needle placement and effective medication delivery.
The research employs a prospective, randomized, clinical trial with a sample of patients scheduled for lumbar spine decompression and fusion surgery. Participants are randomly assigned to either the plain bupivacaine or dexamethasone-adjuvant group. Painscores, assessed through standardized pain scales, and post operative morphine consumption serve as the primary outcome measure, reflecting the intensity of postoperative pain experienced by the patients. Secondary outcomes include the total consumption of intraoperative fentanyl and isoflurane, time to first analgesic request, postoperative patients’ VAS and satisfaction scores, and incidence of adverse effects.
The findings of this study hold significant implications for perioperative pain management in lumbar spine decompression and fusion surgery.