Appendicectomy, Postoperative Analgesia, Regional Anaesthesia
Conditions
Brief summary
this aim of this study is to compare the analgesic effect of Erector spinae plane (ESP) block and lateral transversus abdominis plan (TAP) block in patients undergoing open appendectomy.
Detailed description
regional technique according to randomization will be given after induction of general anesthesia Fentanyl boluses of 1 mcg/kg will be given in case of inadequate analgesia. Inadequate analgesia identified by 20% increase in the heart rate and/or systolic blood pressure from baseline measurement. postoperative analgesia: regular paracetamol 1 g/6 hours (intravenously at first then orally once the oral feeding is resumed) and 75 mg diclofenac (intramuscularly at first then orally once the oral feeding is resumed). If Numeric rating scale (NRS) is \> 3 intravenous titration of 2 mg morphine is given slowly to be repeated after 30 minutes if pain persisted
Interventions
OTHERErector Spinae Plane Block
Patients will receive the ESP block at the level of the 10th thoracic (T10) transverse process using a linear 6-13 MHz ultrasound transducer. A 20 mL of 0.25% bupivacaine will be injected below the muscle
OTHERTransversus abdominis plane (TAP) block
Patient will received TAP block using the lateral approach while in supine position. A 20 mL of 0.25% bupivacaine will be injected after negative aspiration.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* adult patients, undergoing open appendectomy.
Exclusion criteria
* American society of anesthesiologist-physical status \>III, * allergy to any of the study drugs, * coagulopathy * local infection, * history of chronic pain or regular opioid use; * inability to comprehend the Numeric Rating Scale (NRS), * pregnant or lactating women.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total morphine consumption | from extubation until 24 hours postoperative | mg |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| numeric rating scale | AT 0.5, 2, 6, 12, and 24 hours postoperative. | a scale of 0-10, where 0 means "no pain" and 10 means "worst imaginable pain" |
| quality of recovery | 24 hours after suregry | assessed using Quality of recovery-15 (QOR-15); Consists of 15 items evaluating five dimensions of health: physical comfort, physical independence, psychological support, emotional state, and pain. Scoring Range: Each item is rated on an 11-point numerical scale (0 to 10). The total score ranges from 0 (extremely poor recovery) to 150 (excellent recovery). |
Countries
Egypt
Contacts
CONTACTMaha Mostafa, MD
Outcome results
None listed