None listed
Conditions
Brief summary
Our primary aims are to compare the effects of ESP and oblique subcostal TAP block on postoperative pain scores and opioid consumptions after laparoscopic cholecystectomy surgery. Our hypothesis is that ESP will reduce postoperative pain scores and opioid consumption of the patients more significantly than TAP block. Our secondary aims is to compare the intraoperative fentanyl need of the groups. Our hypothesis is that the fentanyl need in ESP group will be lower than TAP group.
Interventions
In the operating room, all of the patients will receive a standard monitoring including electrocardiography, non-invasive blood pressure, peripheral oxygen saturation and bi-spectral index monitoring. An anesthesiologist will perform anesthesia inductions with intravenous 2-3 mg kg-1 propofol, 1 mcg kg-1 fentanyl and 0.6 mg kg-1 rocuronium bromide. After each patient's BIS score decreases to 40–60, endotracheal intubation will be performed. Intravenous 4 mg ondansetron will be applied for postop
In the operating room, all of the patients will receive a standard monitoring including electrocardiography, non-invasive blood pressure, peripheral oxygen saturation and bi-spectral index monitoring. An anesthesiologist will perform anesthesia inductions with intravenous 2-3 mg kg-1 propofol, 1 mcg kg-1 fentanyl and 0.6 mg kg-1 rocuronium bromide. After each patient's BIS score decreases to 40–60, endotracheal intubation will be performed. Intravenous 4 mg ondansetron will be applied for postoperative nausea and intravenous 50 mg dexketoprofen trometamol will be applied as a part of multimodal analgesia. Immediately after intubation, the patients in the first group (Group ESP) will be placed in lateral decubitus position. The anesthesiologist of the operating room will locate a high-frequency linear ultrasound probe in longitudinal orientation at the level of T7 spinous process and then place 3 cm laterally from the midline. The ultrasound landmarks T7 transverse process and overlying erector spinae muscle will be identified. Under aseptic conditions, the anesthesiologist will insert a 80 mm 21-gauge block needle in-plane at an angle of 30-40 degrees in cranial-to-caudal direction until the tip contact the T7 transverse process. After the hydrodissection with 2-3 mL of isotonic saline solution confirms correct needle tip position, 20 mL of 0.375% bupivacaine will be injected deep into the erector spinae muscle. The same procedure will be performed to the contralateral side. All of the patients will receive 4-6% end-tidal desflurane in the 3 lt of 40% O2 and 60% N2O for maintenance of anesthesia. The minimum alveolar concentration of desflurane will be targeted to reach a BIS value between 40-60. At the end of the operation, postoperative analgesia will be maintained with intravenous patient-controlled analgesia (PCA) device in all of the patients. The PCA device will administer 10 mg tramadol as bolus dose with a 15 minute lock-time, and no basal infusion.
Sponsors
Basak ALTIPARMAK
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 70 Years
Healthy volunteers
No
Inclusion criteria
Patients with ASA physical status I-III, between 18-70 years old, scheduled for a laparoscopic cholecystectomy
Exclusion criteria
The patients with coagulation disorder, known allergy to local anesthetics, infection at the injection site of the block, advanced hepatic or renal failure, chronic opioid consumption and body mass index?? equal to or higher than 35 kg m-2.
Outcome results
None listed