Perioperative Analgesia
Conditions
Keywords
retrosuperior costotransverse ligament block, erector spinae block, laparoscopic cholecystectomy
Brief summary
This study aims to compare the analgesic effect of retro superior costotransverse ligament space block vs erector spinae plane block to Achieve high-quality perioperative opioid-sparing effect and postoperative analgesia after laparoscopic cholecystectomy with optimum hemodynamic stability and high patient and surgeon satisfaction
Detailed description
This study aims to compare between retro superior costotransverse ligament space block vs erector spinae plane block * To compare the analgesic outcomes (time to first analgesic request, total amount of analgesic consumption and pain scores by NRS) * To assess the block performance time required to perform each technique . * To compare intraoperative parameters (hemodynamics and intraoperative fentanyl consumption) * To assess patient, surgeon satisfaction and complications of the block.
Interventions
PROCEDURERetrosuperior costotransverse ligament block group
The patient will receive retrosuperior costotransverse ligament block
PROCEDUREErector spinae block group
The patient will receive erector spinae block.
Sponsors
Zagazig University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
anesthesiologist not sharing in the study will assess outcomes
Intervention model description
Achievement of high-quality perioperative opioid-sparing effect and postoperative analgesia for laparoscopic cholecystectomy with optimum hemodynamic stability and high patient and surgeon satisfaction by comparing retrosuperior costotransverse ligament block and erector spinae block in laparoscopic cholecystectomy
Eligibility
Sex/Gender
ALL
Age
21 Years to 64 Years
Healthy volunteers
Yes
Inclusion criteria
1. patient acceptance 2. Age: 21-64 years old. 3. Sex: both sexes. 4. Physical status: ASA I & II. 5. Body mass index (BMI): 18.5 - 30 kg/m2. 6. Type of operations: elective laparoscopic cholecystectomy. 7. Duration of surgery not more than 2 hours.
Exclusion criteria
1. Known hypersensitivity to lidocaine or bupivacaine. 2. Patients with respiratory insufficiency. 3. Coagulation disorders or taking drugs affect surgical hemostasis. 7\. Patients with pre-existing neurological deficits. 8. Uncooperative patient or with altered mental status. 9. Patient with advanced cardiovascular or respiratory diseases
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The time to first call to rescue analgesia | 24 hours | The time to first call to rescue analgesia( the interval between the block injection till the NRS more than or equal 4) (naluphine) will be recorded |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total intraoperative fentanyl consumption | duration of surgery (up to 2 hours) | Total intraoperative fentanyl required other than the induction dose in micrograms |
| Pain intensity by Numerical Rating Scale | 30 minutes after arrival to post anesthesia care unit , 2hours, 4hours, 6hours, 8hours, 12hours, 18 hours and 24hours postoperative | Analgesic parameters (Pain intensity at rest and at movement) by using Numerical Rating Scale (NRS) which will explained to patient as follows:0=no pain and 10= worst pain |
| total amount of rescue analgesia | 24 hours | total amount of rescue analgesia if NRS≥4. in the first 24 hours. |
| To assess block characteristics (block performance time) | 1 hour | To assess block characteristics (block performance time) in minutes |
| Patient's satisfaction | 24 hours | all patient's satisfaction: The patients will be asked to rate the overall degree of satisfaction of the analgesia by using a 5-points likert-like verbal scale (1 = very dissatisfied analgesia, 2 = dissatisfied analgesia, and 3 = neutral, 4=satisfied analgesia, and 5=very satisfied analgesia) |
| complication of the block | 24 hours | complication of the block( heamatoma,local anesthetic toxicity,infection) |
| Intraoperative hemodynamics (Heart Rate and Mean Arterial Pressure) | every 5 minutes in the first 30 minutes then every 10 minutes till the end of surgery | Intraoperative hemodynamics every 5 minutes in the first 30 minutes then every 10 minutes till the end of surgery |
Countries
Egypt
Contacts
Primary ContactDina Salem, MD
Backup ContactMarwa Medhat, MD
Outcome results
None listed