Pain, Postoperative, Obesity, Analgesia
Conditions
Brief summary
The aim of this work is to compare the analgesic efficacy of laparoscopic transversus abdominis plane block, performed by the surgeon to ultrasound-guided erector spinae plane block, performed by the anesthetist, in patients with obesity undergoing bariatric surgery.
Detailed description
This is a randomized controlled trial which will include patients with obesity undergoing bariatric surgery. The patients will be randomly allocated into two groups: transversus abdominis plane block group and erector spinae plane block group. The block will be performed after induction of general anesthesia. Preoperative evaluation and preparation will include history-taking, laboratory investigation, fasting recommendations, and optimization of the medical status. The two groups will receive standard induction and maintenance of anesthesia. After the end of the operation, patients will receive standard care according to the local protocols and the enhanced recovery recommendations. Patients will be monitored according to the pain-related outcomes as well as hemodynamic parameters.
Interventions
PROCEDURETransversus abdominis block
The block will be performed by the surgeon by injecting local anesthetic at the beginning of surgery under the guidance of the laparoscope.
PROCEDUREErector spinae block
The block will be performed by the anesthetist by injecting local anesthetic after induction of anesthesia under the guidance of the ultrasound.
PROCEDUREBariatric surgery
Laparoscopic bariatric procedure will be performed
DEVICEEndotracheal intubation
An endotracheal tube will be inserted as a part of general anesthesia to all patients
DRUGPropofol
The patients will receive propofol for induction of anesthesia
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Patients with obesity undergoing laparoscopic bariatric surgery under general anesthesia.
Exclusion criteria
* Allergy to local anaesthetic. * Bleeding disorders. * Obstructive sleep apnea. * inability to understand the numerical rating scale for pain assessment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Numerical rating scale | 24 hours after surgery | This is a scale for pain assessment which ranges between 0 and 10 with the highest level of pain having score 10 and lowest level of pain having score 0 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Consumption of analgesia | 24 hours after surgery | This is the total consumption of nalbuphine by the patient measured in milligrams |
| Heart rate | 24 hours after surgery | This is the number of heart beats measured as frequency of heart beats in one minute. |
| Systolic blood pressure | 24 hours after surgery | This is the systolic arterial blood pressure measured in mmHg. |
| Vomiting | 24 hours | This is the incidence of vomiting after surgery measured as the frequency of patients with vomiting. |
| Diastolic blood pressure | 24 hours | This is the diastolic arterial blood pressure measured in mmHg. |
Countries
Egypt
Outcome results
None listed