Erector Spinae Block, Enhanced Recovery After Surgery (ERAS) Protocol, Opioid
Conditions
Brief summary
Hystrectomy is a surgical procedure that involves removal of uterus from the body of patient using a lower abdominal incision. This is an extremely painful procedure which causes discomfort and greatly increases opioids consumption in the peri-operative period. This can be reduced by using nerve blocks such as Erector spinae plane block.
Detailed description
Total abdominal hystrectomy is associated with significant pain due to large abdominal incision and significant surgical dissection. This greatly increases the consumption of Opioid in the peri-operative period. High dose opioid consumption is associated with constipation, nausea, vomiting and respiratory depression. This significantly hampers post operative recovery. Fascial plane blocks such as Erector spinae block provides significant analgesia greatly reducing opioid consumption and there by reducing the associated side effects.
Interventions
Bilateral Erector Spinae Block at T10 level using 30ml of 0.25% Bupivacaine will be administered under Ultrasound guidance before surgical incision.
DRUGPlacebo
Bilateral Erector Spinae Block at T10 level using 30ml of Normal saline will be administered under Ultrasound guidance before surgical incision.
Sponsors
Kulsoom International Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
16 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
* American Society of Anesthesiologists (ASA) class: I, II and III . * Elective Hysterectomy under General Anesthesia.
Exclusion criteria
* Lack of consent * Body mass index \>35 kg/m2 * Allergic to study medicine * Opioid abuse or misuse disorder * Chronic pain
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total Intra-operative Fentanyl consumption | From surgical incision till end of surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total amount of IV Tramadol consumed in post operative period | First 24 hours after surgery | — |
| Post operative pain score | Baseline that is pain score upon arrival in post anesthesia care unit in the post operative period and then at 1hours ,2 hours ,4 hours,6 hours,12 hours and 24 hours in the post operative period | This will be assessed Visual Analog Scale |
Countries
Pakistan
Contacts
Primary ContactWaqas Anjum, Principal Investigator, MBBS, FCPS
Backup ContactAbdul Rehman, MBBS,FCPS
Outcome results
None listed