Analgesia
Conditions
Brief summary
There are very few randomized controlled trials in open splenectomy surgery, which compare paravertebral block with ESP block. The purpose of this randomized controlled trial is to compare the efficacy of ultrasound-guided paravertebral block with ESP block for perioperative analgesia in open splenectomy .
Interventions
patients will receive combined general anesthesia and ultrasound guided erector spinae plane block with 20 ml of bupivacaine 0.2 % at T9 level bilaterally.
patients will receive combined general anesthesia and ultrasound guided paravertebral block with 7 ml of bupivacaine 0.2 % at T8 and T10 bilaterally.
patients will receive combined general anesthesia and conventional analgesia
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* patients who will be scheduled for indicated open splenectomy surgery in the supine position via left subcostal ,midline or letf subcostal with midline extention incisions * physical status American Society of Anesthesiologists (ASA) II or III.
Exclusion criteria
* Patients who refuse to participate * patients with body mass index (BMI) \>35 kg/m2 * infection at the site of injection * coagulopathy, severe thrombocytopenia \<50×103 * spine deformity * history of opioid dependence * polytrauma patients with dorsal spine fracture * urgent abdominal exploration for splenectomy in heamodynamically unstable patients * history of allergy to opioids or local anesthetics * history of allergy to opioids, or local anaesthetics.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| First time to analgesic requirement | 1st 24 hour | all patients received an IV -PCA system (Accufuser M8P, 60 mL; Woo Young Meditech Co, S.Korea). PCA was prepared with 60 mL of isotonic saline containing 60 mg morphine, and the selected system was adjusted to infuse a 1 mL bolus dose with a lockout interval of 15 minutes while the basal flow rate was switched off. Breakthrough pain was managed with 2mg morphine. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| total analgesic consumption | 1st 24 hour | The total dose of rescue analgesics(morphine) required in 24 hours will be recorded. |
| Numerical rating scale (NRS) | 1st 24 hour | All patients will be monitored in the postoperative period for pain by the NRS score at rest and movement at immediate postoperative (0 min), 30 min, 1, 2, 6,12, and 24 hours. |
Countries
Egypt
Outcome results
None listed