External Oblique Block, Laparoscopic Cholecystectomy, Transversus Abdominis Plane Block
Conditions
Brief summary
Postoperative pain management is a critical aspect of recovery following laparoscopic cholecystectomy, a commonly performed procedure for symptomatic gallbladder disease. Effective analgesia not only enhances patient comfort but also facilitates early mobilization, reduces the incidence of complications, and improves overall outcomes. Oblique subcostal transversus abdominis plane block (OSTAP), one of the regional anesthesia techniques, is used in middle and upper abdominal surgeries OSTAP blocks the T6-9 intercostal nerves between the rectus abdominis and transversus abdominis muscle. Many studies have shown that OSTAP block reduces the postoperative analgesic and opioid requirement and improves the quality of postoperative pain control.
Detailed description
the potential mechanism of the external oblique intercostal fascial plane block (EOIB) in a cadaver study in which both lateral and anterior branches of the intercostal nerves T7-T10 were stained. Patients to whom this block was applied exhibited consistent dermatomal sensory blockade between T6-T10 in the anterior axillary line and T6-T9 in the midline. It has been shown that this block can be used in the clinical setting for upper abdominal wall analgesia. Various adjuvants have been used to improve the quality and increase the duration of the local anesthetic action in different peripheral nerves and regional block techniques. dexamethasone microspheres have increased the block duration in both human and animal studies. Furthermore, dexamethasone has been shown to possess antiinflamatory action.
Interventions
PROCEDUREdrug injected between the rectus abdominis muscle and the transversus abdominis muscle
20 ml of 0.25% bupivacaine + 8 mg dexamethasone between the rectus abdominis muscle and the transversus abdominis muscle on both sides
PROCEDUREdrug injected in the external oblique intercostal plane on both sides
20 ml of 0.25% bupivacaine+ 8 mg dexamethasone into the external oblique intercostal plane on both sides
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Adult patients aged 18-60 years. 2. Gender: Both males and females. 3. BMI less than 35 kg/m2 4. Scheduled for laparoscopic cholecystectomy surgery 5. American Society of Anesthesiologists - ASA - I & II
Exclusion criteria
1-ASA physical status more than II. 2-History of allergic response to local anaesthetics or any of the medications used in the study \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the first analgesic request depending on Numeric Rating Scale | 24hours | the first analgesic request depending on Numeric Rating Scale |
Countries
Egypt
Contacts
Primary ContactGhada Ghada Abo Elfadl, Asossciated professor
Outcome results
None listed