Postoperative Pain
Conditions
Brief summary
This prospective observational study aims to evaluate the relationship between ultrasound-derived rectus abdominis muscle thickness and thickening fraction and postoperative opioid consumption in geriatric patients undergoing abdominal surgery. Preoperative ultrasonographic measurements will be performed during routine clinical care, and postoperative pain scores and analgesic requirements will be recorded within the first 24 hours. The findings may help improve individualized analgesic strategies by identifying patient-specific predictors of postoperative opioid needs.
Interventions
Ultrasound-guided rectus sheath block will be performed as part of routine clinical practice in geriatric patients undergoing abdominal surgery. No additional intervention will be introduced for study purposes. Ultrasound-derived rectus abdominis muscle thickness and thickening fraction will be measured preoperatively, and postoperative opioid consumption and pain scores will be recorded within the first 24 hours.
Sponsors
Istinye University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥65 years * Scheduled for elective midline abdominal surgery * ASA physical status I-III * Planned to receive bilateral ultrasound-guided rectus sheath block as part of routine clinical practice * Provided written informed consent
Exclusion criteria
* Known allergy or hypersensitivity to local anesthetics * Infection or skin lesion at the injection site * Systemic infection or sepsis * Coagulopathy (INR \>1.5 or platelet count \<100,000/mm³) * Use of therapeutic anticoagulation not safely managed perioperatively * History of previous midline laparotomy * History of abdominal mesh implantation or abdominal wall reconstruction * Significant abdominal wall pathology (e.g., large hernia) affecting anatomy * Neuromuscular disease (e.g., myasthenia gravis, ALS, muscular dystrophy) * Inability to perform required maneuver for dynamic ultrasound measurement * Moderate to severe cognitive impairment or poor cooperation * Body mass index (BMI) \>40 kg/m² * Cachexia or severe malnutrition * Chronic opioid use (≥3 months) * Chronic pain syndromes requiring regular analgesic use * Alcohol or substance abuse * Emergency surgery * Use of additional regional anesthesia techniques (e.g., epidural, TAP block) * Inadequate ultrasound visualization of the target anatomical plane
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Total Opioid Consumption | First 24 hours postoperatively | Total opioid consumption within the first 24 hours after surgery will be recorded and converted to morphine equivalents (mg). This measure will be used to evaluate the association between ultrasound-derived rectus abdominis muscle parameters and postoperative analgesic requirements. |
Countries
Turkey (Türkiye)
Contacts
CONTACTİlke Dolgun
Outcome results
None listed