Abdominoplasty, Spinal Anaesthesia, Transversus Abdominis Plane Block (TAP Block)
Conditions
Brief summary
The primary outcome is the time to first request of opioid analgesia. The secondary outcomes are intraoperative analgesic needs, incidence of conversion to general anaesthesia, the total opioid dose in 24 hours, Visual analogue scale (VAS) scores at 2, 4, 6, 12, and 24 hours postoperatively, and the incidence of postoperative side effects (nausea, vomiting, hypotension, bradycardia, and pruritic).
Detailed description
Abdominoplasty is designed to remove fat, skin laxity, and excess skin with the abdominal skin flap. It is a moderately invasive extraperitoneal procedure with or without liposuction. Ambulatory office-based abdominoplasty procedures have recently increased owing to lower cost and global availability of plastic surgeons in addition to better and safer anaesthetic techniques Spinal anaesthesia has many advantages such as pre-emptive analgesia, better control of pain, suppression of the surgical stress response, preservation of perioperative immune function, preservation of oxygenation and pulmonary functional residual capacity and improved visceral vascular flow in addition to reduction in the incidence of venous thrombotic disease and hence pulmonary embolism, as it facilitates early ambulation The addition of adjuvant drugs to local anesthetics and augmenting spinal anesthesia with peripheral nerve blocks would provide time for prolonged surgeries, and it is the ideal technique for procedures below T3-T4. The investigators assume that performing a transversus abdominis plane block (TAP block) just before spinal anesthesia in abdominoplasty would prolong the duration of postoperative analgesia and lessen the number of cases needing sedation or conversion to general anesthesia when compared to spinal anesthesia alone.
Interventions
DRUGSpinal anaesthesia group (S)
Spinal anaesthesia is given to all patients in S group. They will receive 20 mg of 0.5% hyperbaric bupivacaine plus 25 microgram fentanyl
patient receive Subcostal TAP block before spinal anesthesia. Patients in STAP group will receive 20 ml of 0.25% isobaric bupivacaine for each side before spinal anesthesia
Sponsors
Helwan University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* American Society of Anaesthesiologists physical status grade I and grade II. * Age \> 18 years and less than 65 years. * Both sexes.
Exclusion criteria
* Patient refusal. -. Bleeding or coagulation abnormality. * Local skin infection and sepsis at site of the block. * Known hypersensitivity to the study drugs. * Body Mass Index \> 50 Kg/m2.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The primary outcome is the time to first request of opioid analgesia. | 24 hours | assessment of pain by visual analogue scale (VAS) is a 10 cm horizontal line labeled no pain at one end and worst pain on the other end. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| total dose of intraoperative analgesic needs | 24 hours | opioid dose by microgram |
Countries
Egypt
Outcome results
None listed