Opioid Use, Postoperative Pain
Conditions
Keywords
postoperative pain, opioid consumption, erector spinae plane block, intrathecal morphine
Brief summary
Cesarean section cause severe pain due to surgical incision, abdominal wall retraction and visceral organ movements. Cesarean section can be performed with general anesthesia, spinal anesthesia, epidural anesthesia and combined spinal epidural anesthesia methods. Because of the possibility of aspiration pneumonia in pregnant women are under general anesthesia, the awareness of anesthesia in the mother during the operation due to insufficient anesthesia, unsuccessful intubation, respiratory complications in the mother and newborn and low APGAR scores, regional anesthesia is superior to general anesthesia in elective cesarean section operations. Spinal anesthesia, abdominal wall blocks such as erector spinae plane block, parenteral and intrathecal opioids may be used for postoperative analgesia in cesarean section operations. Intrathecal morphine can cause postoperative nausea-vomiting, itching, respiratory depression. Erector spina plane block can provide effective pain control and reduce opioid consumption. The primary implication of this study is to compare postoperative pain scores and opioid consumption on elective cesarean section patients under spinal anesthesia with intrathecal morphine or erector spina block in addition to spinal anesthesia.
Interventions
PROCEDUREErector Spinae Plane Block (bilaterally, via 20ml % 0.25 bupivacain) and Intrathecal Morphine (100 mcg)
Comparison of the postoperative opioid consumptions between Erector Spinae Plane Block (bilaterally, via 20ml % 0.25 bupivacain) and Intrathecal Morphine (100 mcg)
Sponsors
Marmara University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Patients between 18 and 40 years old, ASA (American Society of Anesthesiologists) score I-II, undergoing elective cesarean section
Exclusion criteria
* Emergency cesarean section * The patients with major hepatic, cardiovascular or renal disease * The patients for whom spinal anesthesia is contraindicated * The patients who is allergic to any drugs that we use for this study * Patients who declined to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Opioid Consumption | 24 hours | Comparing opioid (tramadol) consumption via intravenous Patient Controlled Analgesia (PCA) device |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain Scores | 24 hours | In a Numerical Rating Scale (NRS), patients are asked to choose the number between 0 and 10, that fits best to their pain intensity. Zero usually represents 'no pain at all' whereas ten represents 'the worst pain ever possible' |
| Rescue analgesia | 24 hours | when the patient's NRS score ≥ 4, diclofenac 75 mg intramuscular is given |
| Side effects of medications | 24 hours | Intravenous and intrathecal opioids can cause nausea-vomiting, itching, respirator depression |
Other
| Measure | Time frame | Description |
|---|---|---|
| Participant satisfaction | 24 hours | Comparing pain with numeric rating scale (NRS) In a Numerical Rating Scale (NRS), patients are asked to choose the number between 0 and 10, that fits best to their pain intensity. Zero usually represents 'no pain at all' whereas ten represents 'the worst pain ever possible' |
| Apgar scores of newborns | 1st and 5th minute after the delivery. | APGAR (Activity, Pulse, Grimace, Appearance, Respiration) score is a measure of the physical condition of a newborn infant. It is obtained by adding points (2, 1, or 0) for heart rate, respiratory effort, muscle tone, response to stimulation, and skin coloration; a score of 10 represents the best possible condition. It may be effected by intravenous or intrathecal opioids that is given to mother. |
Countries
Turkey (Türkiye)
Outcome results
None listed