Inguinal Hernia
Conditions
Keywords
TAP block,, Morphine,, Inguinal hernia
Brief summary
This study is conducted to determine whether morphine added to bupivacaine in ultrasound guided (USG) transversus abdominis plane (TAP) block has beneficial effects than bupivacaine alone in providing postoperative analgesia for inguinal hernia surgery.
Detailed description
Total of forty adult patients of American Society of Anaesthesiologists (ASA) physical status ( PS) I - II scheduled for elective inguinal hernia surgery under spinal anaesthesia were recruited in this study after getting written informed consent. They were randomized to undergo ipsilateral USG TAP block with 20 ml of 0.25 % bupivacaine (group B) versus 20 ml of 0.25 % bupivacaine with 3 mg morphine (group BM). Patients were followed postoperatively for the 24 hours by a blinded investigator for monitoring of number of rescue analgesic consumed, duration of analgesia, numerical rating scale (NRS) at rest and on cough and any adverse effects.
Interventions
COMBINATION_PRODUCTbupivacaine and morphine
Bupivacaine group will receive 0.25% bupivacaine 20 ml in TAP block. Bupivacaine morphine group will receive 0.25% bupivacaine 20 ma with 3 mg morphine in TAP block.
Sponsors
B.P. Koirala Institute of Health Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
* Anaesthetic technician will prepare the study drug * Anaesthesiologist who is blind to the study drug will perform UG TAP block and collect data intra and post-operatively. * Patient will also be blind about the drug administered.
Intervention model description
After obtaining written informed consent from a total of 40 patients fulfilling inclusion criteria will be enrolled. A 40 envelopes with number indicating the sequence of the patient on the outside and the allocated group and study drug inside will be made by an anaesthesiologist. An anaesthetic technician will prepare the study drug. The participants, clinicians and the investigator who is involved in patient assessment and collecting data postoperatively will be blinded. The study groups received the following study medication Group B - 0.25% bupivacaine 20 ml in TAP block Group BM - 0.25% bupivacaine 20 ml with 3 mg morphine in TAP block
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
ASA I to III Elective surgery
Exclusion criteria
* Patient's refusal * BMI \> 35 kg/m2 or \< 18 kg/m2 * Allergic or contraindication to drugs used in study * Coagulopathy * Local site infection * Spine deformity * Uncooperative or psychological illness * Inability to comprehend pain scale * Drugs not injected in target area
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| • Duration of postoperative analgesia • Postoperative analgesic requirement | Till 24 hour after surgery | Time from TAP block to first request of analgesic is considered as duration of analgesia Less requirement of rescue analgesic is considered as better |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| • NRS for pain at rest and on cough between the groups • Any side effects | Till 24 hour after surgery | Group with higher NRS score is considered a less effective Group with increase side effects is considered as not acceptable |
Countries
Nepal
Outcome results
None listed