Obesity, Morbid, Pain Management, Pulmonary Functions
Conditions
Keywords
obesity, pain management, pulmonary functions, respiratory function test
Brief summary
Adequate postoperative analgesia is difficult to achieve in patients undergoing laparoscopic sleeve gastrectomy (LSG). Epidural anesthesia is technically difficult due to subcutaneous fat, which increases the risk of serious complications. Moreover, patients in this condition often have comorbidities that require anticoagulation therapy. Although ultrasound-guided Transversus Abdominis Plane (TAP) block may be useful, it is still controversial. Recently, modified thoracoabdominal nerve block via perichondrial approach (M-TAPA) has been reported as a new and promising technique that provides effective analgesia in the anterior and lateral thoracoabdominal wall. The most common reason for hospitalization after laparoscopic surgery is pain after nausea and vomiting. In addition, superficial and tachypneic breathing resulting from the patient's inability to breathe deeply with pain causes closure of small airways and increase in intrapulmonary shunts, resulting in hypoxia. Postoperative pain management is important not only to prevent pain but also to reduce pulmonary complications that may occur due to changes in lung function and to reduce mortality and morbidity by controlling the stress response. In this study, The investigators investigated the effect of modified thoracoabdominal nerve block via perichondrial approach (M-TAPA) on pulmonary function in patients undergoing laparoscopic bariatric surgery under general anesthesia.
Interventions
PROCEDUREModified thoracoabdominal nerves block through perichondrial approach (M-TAPA)
application local anesthetic between internal oblique and transversus abdominis muscle at the level of 10th costal cartilage
Sponsors
Zonguldak Bulent Ecevit University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Between 18-65 years old * ASA I-II-III risk group * Patients whose approval was obtained through an informed consent form * Will undergo laparoscopic bariatric surgery * Patients who will cooperate for the PFT test
Exclusion criteria
* \<18 years and \>65 years * ASA ≥ IV * 50% below the expected value in SFT * Known diaphragmatic paralysis * Having had a myocardial infarction within 1 month * Dementia or confusion * Lack of cooperation * Those with respiratory disease * Congestive heart failure * Unstable hypertension * Had thoracoabdominal surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| FEV1/FVC ratio | during the procedure | Pulmonary function |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Numerical Rating Scale | during the procedure | pain assessment tool (minimum: 0, maximum: 10) |
| opioid consumption | 24 hours after surgery | need of opioid postoperatively |
Countries
Turkey (Türkiye)
Outcome results
None listed