None listed
Conditions
Brief summary
Preventing pain in the post-cesarean period has positive effects on mobilizing and breastfeeding. Peripheral and truncal analgesia methods are included in the multimodal analgesia regimen, including preoperative and postoperative period. Transversus abdominis plane block (TAP) and quadratus lumborum block (QL) are frequently and effectively used in laparoscopic abdominal surgery, inguinal hernia, laparotomy and cesarean surgery. Recent studies have shown that TAP block and QL block can help to maintain analgesia and reduce the amount of opioid used after cesarean surgery. Our aim is to compare postoperative analgesic efficacy of TAP block and QL block after cesarean surgery which is under general anesthesia and to evaluate patient satisfaction.
Interventions
Comparison of Ultrasound guided transversus abdominis plane (TAP) block and quadratus lumborum (QL) block for pain relief after caesarean surgery which is perforemed under general anesthesia.
Equipment
Ultrasound – linear array probe
22G 100mm Stimuplex needle
Study drug – 0.3ml/kg 0.25% bupivacaine
Betadine antiseptic for skin preparation
Standard monitoring and resuscitation equipment
Patient controled analgesia device
All patients will receive standard premedication, monitoring and anest
Comparison of Ultrasound guided transversus abdominis plane (TAP) block and quadratus lumborum (QL) block for pain relief after caesarean surgery which is perforemed under general anesthesia. Equipment Ultrasound – linear array probe 22G 100mm Stimuplex needle Study drug – 0.3ml/kg 0.25% bupivacaine Betadine antiseptic for skin preparation Standard monitoring and resuscitation equipment Patient controled analgesia device All patients will receive standard premedication, monitoring and anesthesia care. Adequate preparations will be made for the possibility of difficult airway. Propofol 2-3 mg/kg iv and rocuronium 1 mg/kg iv will be used for induction of anesthesia. All patients will recieve fentanyl 1.5 mcg/kg iv and tenoxicam 20 mg iv After the completion of the surgical procedure one of the analgesia methods used for postoperative analgesia will be performed. TAP block technique The patient is in the supine position. Ultrasound will be positioned in the mid axillary line in the axial plane half way between the iliac crest and the costal margin. Structures to be identified: subcutaneous fat, external oblique muscle, internal oblique muscle, transversus abdominis muscle, peritoneum and intraperitoneal structures. The needle is inserted 'in plane' and directed to lie between the internal oblique and transversus abdominis under ultrasound guidance. To confirm location, 2ml of local anaesthetic can be injected. Patient will receive 0.3ml/kg 0.25% bupivacaine on each side QL block technique The patient is in the supine position. Ultrasound positioned in the mid axillary line in the axial plane half way between the iliac crest and the costal margin. Probe will be moved posteriorly until the QL muscle is confirmed . The needle tip will be placed at the anterolateral border of the QL at its junction of QL with transversalis fascia, and the local anesthetic will be injected. Patient will receive 0.3ml/kg 0.25% bupivacaine on each side
Sponsors
Bursa Yuksek Ihtisas Training and research Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 49 Years
Healthy volunteers
Yes
Inclusion criteria
Elective caesarean sections ASA 1 to 2 performed under general anesthesia Written informed consent.
Exclusion criteria
Patient refusal Local infection at the site of injection Allergy to study medications Coagulopathy Inability to speak Turkish language
Outcome results
None listed