Rhomboid Intercostal Plane Block, Thoracic Erector Spinae Plane Block, Ultrasound, Upper Abdominal Surgery
Conditions
Brief summary
The aim of the work is to evaluate the analgesic efficacy of ultrasound guided rhomboid intercostal plane block versus ultrasound guided thoracic erector spinae block in patients undergoing upper abdominal surgery.
Detailed description
Abdominal surgery is one of the most definitive and mainstay treatment options for abdominal pathologies in clinical practice. Acute postoperative pain is a major challenge in the postoperative period. The improved safety and efficacy that ultrasound brings to regional anesthesia helped promote its use and realize the benefits that regional anesthesia has over general anesthesia, such as decreased morbidity and mortality, superior postoperative analgesia, cost-effectiveness, decrease postoperative complications and an improved postoperative course .
Interventions
OTHERControl group
No block will be performed, and patient will receive general anesthesia (GA) only.
The patients in this group will receive ultrasound -guided rhomboid intercostal plane block after induction of general anesthesia. The rhomboid intercostal block will be performed at the T6 levels, bilaterally.
OTHERErector spinae plane block
The patients in this group will receive ultrasound -guided Erector spinae plane block after induction of general anesthesia. Erector spinae plane block will be performed at the level of T9 bilaterally.
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
21 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged 21-65 years. * Both gender. * American Society of Anesthesiologists (ASA) classification I-II. * Presented for elective upper abdominal surgery.
Exclusion criteria
* Patients refused to participate. * Patients with known or suspected allergy to the used medication. * Patients with preoperative chronic pain. * Patients with major cardiac, renal, respiratory, or hepatic disease. * Patients with potential risk of coagulopathy. * Obese patients with body mass index (BMI) \>35.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total morphine consumption | 24 hours postoperatively | Rescue analgesia will be provided in the form of IV morphine 3 mg boluses if the patient indicates The visual analogue scale (VAS). ≥ 4 with maximum dose 20 mg for 24 hours. The total amount of morphine (mg) given will be recorded for the 3 groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Degree of pain | 24 hours postoperatively | Postoperative pain will be assessed by visual analogue scale (VAS) 30 min from admission to PACU, 2, 4, 6, 12, 18 and 24 h postoperative (0= no pain, 10= sever pain). |
| Time to 1st request of rescue analgesia | 24 hours postoperatively | Time to 1st request for the rescue of analgesia (time from the end of surgery till first dose of morphine administrated ) will be recorded. |
| Heart rate | Every 15 min till the end of surgery | Heart rate will be measured preoperative, after induction, after receiving block and every 15 min till the end of surgery |
| Mean arterial blood pressure | Every 15 min till the end of surgery | Mean arterial blood pressure will be measured preoperative, after induction, after receiving block and every 15 min till the end of surgery |
| Incidence of side effects | 24 hours Postoperatively | Any undesirable adverse events will be treated and recorded (e.g., bradycardia, hypotension, pneumothorax, hematoma, nerve injury and nausea, vomiting, local anesthetic systemic toxicity (LAST), respiratory depression or any other complication). |
Countries
Egypt
Contacts
Primary ContactOmima M Eldeeb, Master
Outcome results
None listed