Block
Conditions
Brief summary
Upper abdominal incisions, such as the oblique subcostal laparotomy, can cause severe pain and can lead to significant respiratory impairment. Erector spinae plane (ESP) block is the deposition of local anaesthetic (LA) in the interfascial plane at the paraspinal region. It provides effective visceral and somatic analgesia. External oblique intercostal plane (EOIP) block is a newly described block at which local anaesthetic (LA) is deposited in the interfascial plane deep to external oblique muscle at the sixth intercostal space. It provides blockade of the thoracoabdominal nerves at the level of T6 to T10. In this study, the investigators compare between ultrasound (US) guided external oblique intercostal plane block and erector spinae plane block, in providing postoperative analgesia for upper abdominal surgeries
Interventions
PROCEDUREexternal oblique intercostal plane block
o EOIP Group (ŋ=25): Patients will receive ultrasound guided External oblique intercostal plane block with 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 total volume of 20 ml.) at the end of procedure, unilaterally or bilaterally according to the surgery.
PROCEDUREerector spinae plane block
o ESP Group (ŋ=25): Patients will receive ultrasound guided Erector spinae plane block with 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 total volume of 20 ml.) at the end of procedure, unilaterally or bilaterally according to the surgery.
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Patients with American Society of Anesthesiologists physical status (ASA) I and II. * Both sex. * 20 to 60 years old patients. * upper abdominal surgeries.
Exclusion criteria
* Refusal of the patient to consent. * Patients with ASA status III or IV * Patients with bleeding disorders and coagulopathy (INR≥1.6 & PTT≥50 sec). * Infection at the injection site. * Allergy to local anesthetics. * Patients with ages less than 20 or more than 60 * Patients with pre-existing myopathy or neuropathy. * Patients with chronic pain syndromes. * Patients with history of long acting opioids or steroids preoperatively.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| amount of total 24 hour pethidine consumption (mg) . | 24 hours postoperatively | to measure total 24 hour pethidine consumption postoperatively. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| visual analogue scale (VAS) at rest and movement. | 24 hours postoperatively | recorded postoperative immediately and 2, 4, 6, 8, 12, 18 and 24 hours. The Visual Analogue Scale (VAS) measures pain intensity. The visual analogue scale (VAS) consists of a 10 cm line, with two end points representing 0 (no pain) and 10 (pain as bad as it could possibly be). |
| mean arterial blood pressure (MAP) | 24 hours postoperatively | recorded postoperative immediately and 2, 4, 6, 8, 12, 18 and 24 hours |
| heart rate (HR) | 24 hours postoperatively | recorded postoperative immediately and 2, 4, 6, 8, 12, 18 and 24 hours |
| incidence of postoperative complications (nausea and vomiting) | 24 hours postoperatively | recorded postoperative immediately and 2, 4, 6, 8, 12, 18 and 24 hours |
| time to start mobilization | 24 hours postoperatively | recorded postoperative immediately and 2, 4, 6, 8, 12, 18 and 24 hours |
Outcome results
None listed