Ultrasound, Erector Spinae Plane Block, Oblique Subcostal Transversus Abdominis Plane Block, Laparoscopic Cholecystectomy
Conditions
Brief summary
The aim of this work was to compare the effect of using oblique subcostal transversus abdominis plane (OSTAP) block and erector spinae plane (ESP) block as a part of multi-modal analgesia technique in patients undergoing laparoscopic cholecystectomy.
Detailed description
Laparoscopic cholecystectomy is a commonly performed surgery and requires multi-modal analgesia for better control of pain. Untreated post-operative pain has many consequences, including patient dissatisfaction, transition into chronic pain, delayed discharge from the hospital, and increased healthcare costs. Many inter-fascial plane blocks like oblique subcostal transversus abdominis plane (OSTAP) block and recently, erector spinae plane (ESP) block have been utilized as a part of multi modal analgesia technique in many abdominal surgeries.
Interventions
OTHERErector spinae plane block
Patients received ultrasound-guided erector spinae plane block.
Patients received ultrasound-guided oblique subcostal transversus abdominis plane block.
Sponsors
Helwan University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Age from 20 to 60 years. * Both gender. * American Society of Anesthesiologists (ASA) grade I and II physical status. * Body mass index (BMI): ≥ 20 kg/m2 and ≤ 35 kg/m2. * Underwent laparoscopic cholecystectomy.
Exclusion criteria
* Patient refusal. * Known sensitivity or contraindication to drugs used in the study (local anesthetics, opioids). * History of psychological disorders and/or chronic pain syndrome. * Contraindication to regional anesthesia, e.g., local sepsis, pre-existing peripheral neuropathies, and coagulopathy. * Severe respiratory disorders such as (severe obstructive pulmonary disease, forced expiratory volume (FEV1), forced vital capacity (FVC) \<50% or severe restrictive pulmonary disease, and adult respiratory distress syndrome). * Severe cardiac disorders such as (heart failure). * Advanced liver disease (elevated liver enzymes more than 3 folds of normal range). * Advanced kidney disease (Decreased creatinine clearance \<40 ml/min). * Pregnancy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Degree of pain intensity | 24 hours postoperatively | The degree of pain intensity was assessed using the Visual Analogue Scale (VAS). Each patient was instructed about postoperative pain assessment with the VAS. VAS(0 represents no pain while 10 represents the worst pain imaginable). It was assessed at 30 minutes, 2, 4, 6, 8, 12, 16, 20, and 24 hours postoperatively. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to first rescue analgesia | 24 hours postoperatively | Time to first rescue analgesia was assessed from the end of surgery to the first dose of morphine administrated |
| Total amount of morphine consumption | 24 hours postoperatively | When a patient complains of pain equivalent to the Visual Analogue Scale (VAS) ≥ 3, rescue analgesia is given in the form of morphine (0.05mg/kg) intravenous increments, as needed. |
| Morphine-related side effects | 24 hours postoperatively | Morphine-related side effects such as incidence of nausea and vomiting, respiratory depression (respiratory rate \< 8 breaths/min), bradycardia (heart rate decreases by \> 20% of basal reading), pruritus, and urine retention were recorded. |
| Local anesthetics-related side effects | 24 hours postoperatively | Local anesthetics-related side effects such as lightheadedness, circumoral numbness, tongue paresthesia, drowsiness, irritability, muscle twitches, convulsions, bradycardia, hypotension (mean arterial blood pressure decreases by \> 20% of basal reading), hypoventilation and cardiac arrest were recorded. |
| Incidence of adverse effects of the block technique | 24 hours postoperatively | Signs of adverse effects of the block techniques, such as local site infection, hematoma formation, bowel perforation, or pneumothorax, were recorded. |
Countries
Egypt
Outcome results
None listed