major upper abdominal surgery
Conditions
Interventions
Part1: Intrathecal hydromorphone:The dose of intrathecal hydromorphone will start at 50 µg and be adjusted upwards or downwards. Considering that too small a dose may not provide adequate analgesia, t
Part2- group1: Intrathecal injection of hydromorphone at ED90/ED95 doses.:Based on the data from the first part of the study, we determined the ED90 and ED95 doses of intrathecal hydromorphone, which
Part2- group2: Transversal plane block group :After the induction of general anesthesia, the patient was placed in a supine position. The anesthesiologist performed abdominal disinfection and draping.
Sponsors
West China Hospital, Sichuan University
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Aged >=18 years old; 2. ASA grade I-III; 3. To receive elective upper abdominal surgery under general anesthesia, the operation grade was grade A and the operation duration was >= 2 hours; (Class A operations include radical resection of complex pancreatic cancer, hepatectomy of left and right half of liver tumor, radical resection of bile duct cancer, laparoscopic resection of liver tumor, radical resection of gastric cancer, pancreaticoduodenectomy, etc.); 4. Sign the informed consent form.
Exclusion criteria
Exclusion criteria: 1. Underweight or obese patients (BMI= 30 kg/m^2); 2. There are contraindications for intraspinal manipulation, including patients with coagulopathy (platelet 1.5), puncture site infection, spinal malformation or trauma, and suspected malignant tumor bone metastasis; 3. Patients with chronic pain or chronic opioid use (daily opioid use >=3 months or morphine use >=60mg/d and >=1 month); 4. Allergy to the related drugs in this study; 5. do not agree to the use of a postoperative self-controlled analgesia pump; 6. Patients with language communication disorders, unable to understand preoperative education, research process, and the use of pain relief pump; 7. Participate in other clinical trials within 3 months prior to inclusion in this study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Duration of first need for remedial opioids after surgery; | — |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of moderate and severe postoperative pain;Incidence of postoperative chronic pain;Total opioid consumption;Postoperative rehabilitation index;The NRS score (Numeric Rating Scale) for pain after surgery; | — |
Countries
China
Contacts
Public ContactQian Li
West China Hospital, Sichuan University
Outcome results
None listed