Hysterectomy
Conditions
Keywords
ultrasound-Guided Transversus Abdominis Plane Block
Brief summary
Over 80% of patients who undergo surgery suffer from acute postoperative pain, with 75% of them rating the pain severity as moderate, severe, or extreme. Studies have shown that less than 50% of patients who undergo surgery report adequate relief from postoperative pain. Additionally, if pain is not promptly managed after surgery, it can hinder a patient's ability to walk, potentially causing adverse effects such as thromboembolism, myocardial ischemia, and arrhythmia. The opioid analgesics are most commonly used as parenteral agents to manage post operative pain but the problem of respiratory depression remains to be considered. This study is designed to compare the analgesic effect between dexmedetomidine versus magnesium sulfate as adjuvant to bupivacaine using ultrasound guided Transversus Abdominis Plane block in patients undergoing abdominal hysterectomy
Detailed description
In addition to parenteral opioids and NSAIDS, various other methods used for post operative analgesia are infiltration of local anaesthetic agents, dermal patches, patient-controlled analgesia and epidural catheters, etc. Numerous studies have demonstrated that when enhanced recovery procedures (ERPs) are used, hospital length of stay, time to return to normal function, postoperative ileus duration, thromboembolic complications, morbidity, and all of these factors are all reduced. In order to achieve the best pain treatment, many ERPs use a multimodal approach, decreasing the use of opioids as the primary analgesic in Favor of neuraxial and regional anaesthetic techniques. One of the regional techniques routinely used is the transversus abdominis plane (TAP) block. Its widespread use in abdominal surgeries is due to its technical simplicity and trustworthy analgesia.
Interventions
DRUGbupivacaine 0.5%
patients will receive 18 ml 0.5% bupivacaine (Sunnypivacaine®) using Ultrasound-Guided TAP Block Technique
DRUGDexmedetomidine
patients will receive plus 0.5 µg/kg of dexmedetomidine (Precedex® 100 µg/ml) diluted in 2 ml of normal saline at each side
DRUGMgSO4
patients will receive plus 1.5 mL (150 mg) MgSO4 and 0.5 mL normal saline at each side
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
Patients will be randomly allocated into one of the two study designed groups using computer-generated random numbers table.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* ASA classification I-ll, * Aged \>18 years, * weight 50-85 kg, * Patients who will undergo total abdominal hysterectomy
Exclusion criteria
* • ASA classification I-ll, * Aged \>18 years, * weight 50-85 kg, * Patients who will undergo total abdominal hysterectomy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the time of the first request of rescue analgesia | 24 hours | the time of the first request of rescue analgesia (calculated from the time of the TAP block application) |
Contacts
Primary ContactAbdelrahman Mahfouz Ali, resident doctor
Outcome results
None listed