Post Operative Pain in Total Abdominal Hystrectomy
Conditions
Keywords
post operative pain, total abdominal hystrectomy, TAP Block with ketamine, bupivacaine vs bupivacaine plus ketamine
Brief summary
The goal of this study is to know how effectively TAP block can reduce postoperative pain in total abdominal hystrectomy patients when given ketamine in addition to bupivacaine in TAP block and to compare it with the conventional TAP block with bupivacaine only. The main question it aims to answer is: Does intervention with ketamine in TAP block lowers the postoperative pain measured via visual analog scale and decreases the need for rescue analgesia? Patients will be assessed for pain in PACU( post anesthesia care unit), 6 hours, 12 hours and 24 hours postoperatively. Time of rescue analgesia will also be noted if given.
Detailed description
This is a prospective, randomized, double blind control trial.Patients will be randomly divided into 2 groups; group A and group B with 15 patients in each group. Group A will recive TAP block with 20ml solution of 0.25% bupivacaine on each side of abdomen while group B will recieve 50mg ketamine in addtion to 20ml of 0.25% bupivacaine.The drugs will be prepared by the second anesthesiologist who will not be part of data collection and analysis.Post operative pain will be assessed using VAS score in PACU, after 6 , 12 and 24hours post total abdominal hystrectomy. Inj. tramadol 50mg will be used as rescue analgesia.In addition to inj. pracetamol 1g 8 hourly and inj. ketorolac 30mg 12 hourly, time for administration of rescue analgesia will be noted.
Interventions
20ml of 0.25% bupivacaine inTAP block
DRUGbupivicaine 0.25% + ketamine
20ml of 0.25% of bupivacaine with 50mg ketamine in TAP block
Sponsors
Liaquat National Hospital & Medical College
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
25 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Aged between 25 to 60 years. * ASA grade I \& II. * Undergoing total abdominal hysterectomy.
Exclusion criteria
* BMI \>35kg/m2. * Patient refusal for participation. * Patients with coagulation disorders. * Patents with history of allergy and hypersensitivity to local anesthetic. * Patient having infection at the injection site. * Alcohol or drug abuse. * Cognitive or mental disorder.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| VAS score | At PACU(5 mins after shifting to PACU), 6,12 and 24 hours post-operatively | VAS (visual analog scale ) score noted VAS of \<2 = no pain VAS of 2-4 = mild pain VAS of 5-6 = moderate pain VAS of \>6 = severe pain |
| Time of receiving first rescue analgesia | within first 24 hours postoperatively | time for additional requirment of inj. tramadol 50mg for post operative pain relief |
Countries
Pakistan
Outcome results
None listed