Postoperative Pain
Conditions
Keywords
Cholecystectomy, EOI block, ESP block
Brief summary
To compare the efficacy of USG-guided bilateral External oblique intercostal (EOI) block with Erector spinae plane block (ESPB) for post-operative analgesia after laparoscopic cholecystectomy with a hypothesis that both External oblique intercostal fascial plane block and Erector spinae plane block are effective in providing post-operative analgesia.
Interventions
A high-frequency linear ultrasound probe will be placed in a longitudinal parasagittal orientation at the sixth intercostal space in the anterior midaxillary line. A 21G 10 cm needle will be inserted using an in plane approach. The tip of the needle will be placed into the fascial plane on the deep aspect of the external oblique muscle. A volume of 20 mL of LA mixture (10 mL of bupivacaine 0.5%, 5 mL of lidocaine 2% and 5 mL of normal saline to make a mixture totaling 20 ml.) will be injected. The same procedure will be repeated for the opposite side.
A high-frequency linear ultrasound probe will be placed in a longitudinal parasagittal orientation 2.5-3 cm lateral to the T9 spinous process. The erector spinae muscles will be identified superficial to the tip of the T9 transverse process. A 21G 10 cm needle will be inserted using an in plane approach. The tip of the needle will be placed into the fascial plane on the deep aspect of the erector spinae muscle. The location of the needle tip will be confirmed by visible fluid spread lifting the erector spinae muscle off the bony shadow of the transverse process on ultrasonographic imaging. A volume of 20 mL of Local Anesthetic mixture (10 mL of bupivacaine 0.5%, 5 mL of lidocaine 2% and 5 mL of normal saline to make a mixture totaling 20 ml.) will be injected. The same procedure will be repeated for the opposite side.
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Investigator)
Masking description
triple
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 65 years with a body mass index (BMI) of 18-35 kg/m2, * patients with the American Society of Anesthesiologists (ASA) physical status I/II, * Patients scheduled for elective laparoscopic cholecystectomy.
Exclusion criteria
* Allergy to local anaesthetics, * Infection at the site of injection, * Coagulopathy, * Chronic pain syndromes, * Prolonged opioid medication, * Patients who received any analgesic 24 h before surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Nalbuphine consumption in mg equivalent to morphine dose. | 24 hours postoperatively | mg |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Analgesic drug consumption other than nalbuphine | 24 hours postoperatively | in mg |
| Heart Rate | Intraoperatively at 0, 5,10, 20, and 30 minutes. Then every 15 min thereafter till the end of surgery | beats /min |
| Numerical Rating Scale (NRS) at rest and when coughing | at 1, 2,4 , 8, 16 and 24 hours postoperatively | 11-point scale where 0=no pain and 10=worst pain |
| Incidence of Postoperative nausea & vomiting (PONV) | 24 hours postoperatively | Number of patients developing PONV |
| Shoulder pain | 24 hours postoperatively | Number of patients developing Shoulder pain |
| Mean Arterial Pressure | Intraoperatively at 0, 5,10, 20, and 30 minutes. Then every 15 min thereafter till the end of surgery | mmHg |
Countries
Egypt
Contacts
Primary ContactMagdy M mahdy, MD
Backup ContactAmr M.A. Thabet, MD
Outcome results
None listed