Post Operative Pain
Conditions
Keywords
tap block, esp block, postoperative pain, recovery
Brief summary
The goal of this clinical trial is to evaluate in effect of tap block and esp block on quality of recovery and postoperative pain after laparoscopic hysterectomy. The main question it aims to answer are: Are these two plane blocks used superior to each other? Participants; * will fill out the preoperative questionnaire * will fill out the postoperative questionnaire * will report their pain status according to the NRS score
Detailed description
Standard management of acute pain after surgery consists mainly of systemic opioid narcotics and nonsteroidal anti-inflammatory drugs (NSAIDs). Generally, opiates and NSAIDs are not completely effective at managing pain, and they carry significant risk of addiction and overdose, particularly with prolonged or increased dosing. The concept of multimodal or ''balanced'' analgesia is rapidly becoming the 'standard of care' for preventing post-operative pain. It consists of the use of combinations of analgesics of different classes with different sites of action in an attempt to provide superior pain relief with reduced analgesic related side effects. Local anesthetic injection to block specific nerves has been widely recognized as a useful adjunct in a multimodal approach to postoperative pain management. Erector Spinae Plane (ESP) block is a recently described plane block designed to block the dorsal and ventral rami of the spinal nerves. And this block provides visceral and somatic pain block. Transversus Abdominis plane (TAP) block involves the injection of LA between the transversus abdominis (TA) and internal oblique (IO) muscles.This interfascial plane contains the intercostal, subcostal, iliohypogastric, and ilioinguinal nerves. These nerves give sensation to the anterior and lateral abdominal wall as well as the parietal peritoneum, providing only somatic and not visceral analgesia.
Interventions
PROCEDURETAP block
Bilateral tap block with 20 ml of mixture 2:1:1 (0.5% bupivacaine: 0.9%NaCl: 2% lidocain) for each
PROCEDUREESP block
Bilateral esp block with 20 ml of mixture 2:1:1 (0.5% bupivacaine: 0.9%NaCl: 2% lidocain) for each
Sponsors
Mentese State Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Masking description
Triple (Participant, Care Provider, Investigator)
Intervention model description
This is a double blind, randomized control clinical trial.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Female patients who will undergo hysterectomy under elective conditions * 18- 65 years * ASA I-II patients
Exclusion criteria
* Refusal during registration, request to be excluded from the study, failure to give informed consent * Under 18 years old and upper 65 years old * ASA III-IV patients * Chronic opioid use * Presence of infection at the injection site * Renal failure / Liver failure * Bupivacaine sensitivity * Use of anticoagulants * BMI \< 18,5 , BMI \>35
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Quality of Recovery 40 Questionnaire | 24 hours after surgery. | The global Quality of Recovery-40 aggregate score is a scale from (1 to 5, where: 1 = very poor and 5 = excellent) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pain | 24 hours after surgery. | is a numerical rating scale from (1 to 10, where: 1 is the mildest and 10 the worst possible) |
Other
| Measure | Time frame | Description |
|---|---|---|
| using salvage opiod | 24 hours after surgery. | Additional opioid use for nrs score of 4 and above |
Countries
Turkey (Türkiye)
Contacts
Primary ContactPelin dilsiz eker, MD
Outcome results
None listed