Gastric Cancer, Pain, Postoperative
Conditions
Keywords
Subcostal transversus abdominis plane block
Brief summary
Using random case assignment to investigate the analgesic and sedative effect of intravenous dexmedetomidine and dexmedetomidine as a local anesthetic adjuvant in ultrasound-guided subcostal TAP block in gastric cancer patient undergoing gastrectomy or partial gastrectomy.
Detailed description
The process of the experiment (brief describe) The participant patients will be randomly allocated into three groups: the intravenous dexmedetomidine group (Dex\_iv group), dexmedetomidine adding to local anesthetic as an adjuvant for subcostal TAP block (Dex\_adj group), and Control group. All patients receive gastrectomy or partial gastrectomy in general anesthesia as standard. Thirty minutes before the end of surgery, the patients in Dex\_iv group receive 0.5mcg/kg dexmedetomidine infusion for 30 minutes, while the patients in Dex\_adj group and control group receive 0.125ml/kg 0.9% normal saline IV infusion for 30 minutes. All patients have ultrasound-guided TAP block single injection after the end of surgery and before the tracheal tube extubation. The block agents in Dex\_adj group is 40 ml of 0.375% ropivacaine with 0.5mcg/kg dexmedetomidine, while in Dex\_iv group and control group are only 40ml of 0.375% ropivacaine. The IV PCA pump will be set up before patients awaken in the post-anesthesia care unit. All patients are assessed for the signs of emergence agitation with Riker sedation-agitation scale in the post-anesthesia care unit. The numerical rating scale (NRS) for pain intensity assessment, the opioid consumption via IV PCA pump, and the patients satisfaction will be documented for postoperative 3 days for the impact evaluation of dexmedetomidine in postoperative analgesia in patients undergoing gastric cancer surgery with subcostal TAP block.
Interventions
DRUGDexmedetomidine
0.5mcg/kg intravenous(IV)continuous infusion for 30 minutes, or 0.5mcg/kg adding to local anesthetic for subcostal TAP block
0.125ml/kg intravenously infusion in Dexmedetomidine\_adj group and control group
Sponsors
Kaohsiung Medical University Chung-Ho Memorial Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Caregiver)
Eligibility
Sex/Gender
ALL
Age
20 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* gastric cancer patients undergoing gastrectomy or partial gastrectomy, who receive ultrasound-guided subcostal TAP block and PCA for postoperative analgesia
Exclusion criteria
* surgery involved other visceral organ (eg. combined splenectomy or partial hepatectomy), patients with histories of adverse drug reaction to dexmedetomidine, bradycardia (baseline heart rate \<60 beats/min), any type of atrioventricular block in electrocardiogram (EKG), heart failure, significant renal or hepatic impairment, severe bronchopulmonary disease, any coagulant disorder, and pregnant or breast-feeding woman.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| analgesic effect - pain intensity | postoperative 3 days | postoperative acute pain intensity (numerical rating scale, NRS, 0-10) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| sedative effect | postoperative 2 hours | emergence agitation in post-anesthesia care unit (Riker sedation-agitation scale, 1-7) |
| analgesic effect - opioid consumption | postoperative 3 days | Fentanyl consumption(mcg) via patient-control analgesia (PCA) pump |
Countries
Taiwan
Contacts
Primary ContactMiao-Pei Su, M.D.
Outcome results
None listed