Buccal Mucosal Graft, General Anesthesia, Local Anesthetic Infiltration, Spinal Anesthesia, Urethroplasty
Conditions
Brief summary
This study aims to compare general anesthesia and spinal anesthesia with local anesthetic infiltration for buccal mucosal graft (BMG) in urethroplasty.
Detailed description
Urethroplasty is a surgical procedure aimed at reconstructing the urethra and is considered the standard treatment for bulbar urethral strictures, with different types of tissues used as either grafts or flaps, affecting approximately 300 per 100,000 males. Postoperative pain following urethroplasty with buccal mucosal graft (BMG) is primarily related to the oral graft harvest site. General Anesthesia provides a state of complete unconsciousness, ensuring that patients are free from pain and awareness during the surgery. It can be beneficial in complex cases or when extended manipulation is required, allowing for muscle relaxation and controlled ventilation. On the other hand, spinal anesthesia involves the injection of anesthesia into the cerebrospinal fluid, resulting in targeted numbness in the lower body. This technique can be advantageous for its fast, simple, cost-effective method, rapid onset, lower risk of systemic complications, and preservation of airway reflexes.
Interventions
OTHERSpinal anesthesia
Patients will receive spinal anesthesia with local anesthetic infiltration.
OTHERGeneral anesthesia
Patients will receive general anesthesia.
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
21 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Male patient age ≥ 21 years. * American Society of Anesthesiologists (ASA) classification I-II. * Patient scheduled for urethroplasty.
Exclusion criteria
* Patients who are taking analgesics for chronic illness or have a history of substance abuse. * Patients who are unable to describe their postoperative pain (e.g., neuropsychiatric disorder). * Patients with known local anesthetics and opioid allergy. * Patients with infection at the site of the needle puncture.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Degree of pain | 24 hours postoperatively | Each patient will be instructed about postoperative pain assessment with the Numerical rating Scale (NRS). NRS (0 represents no pain; (1-3) mild pain; (4-6) moderate pain; (7-10) severe pain. NRS will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative morphine consumption | 24 hours postoperatively | Rescue analgesia of morphine will be given as 3 mg bolus if the Numerical rating Scale (NRS)\> 3 to be repeated after 30 min if pain persists until the NRS\< 4. |
| Operative time | Till discharge to post-anesthesia care unit (Up to 2 hours) | Operative time will be recorded from the induction of anesthesia to discharge to the post-anesthesia care unit (PACU). |
| Length of hospital stay | Till discharge from hospital (Up to one week). | Length of hospital stay will be recorded from admission till the discharge from the hospital. |
| Patient satisfaction | 24 hours postoperatively | • Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely unsatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied). |
| Incidence of complications | 24 hours postoperatively | Incidence of complications such as urinary retention, nausea, headache, local anesthetic systemic toxicity (LAST), bradycardia, hypotension, nausea, vomiting, respiratory depression or any other complication will be recorded. |
Countries
Egypt
Contacts
Primary ContactAya Allah H Elbahy, Master
Outcome results
None listed