Acute Postoperative Pain in Urological Surgery, Regional Anaesthesia
Conditions
Keywords
Erector spinae plane block, percutaneous nephrolithotomy, postoperative analgesia, regional anaesthesia, morphine
Brief summary
This study is planned as a single-center randomized single blinded study and includes patients undergoing percutaneous nephrolitotomy.The aim of the study is to evaluate the effect of ultrasound guided erector spinal plane block on postoperative analgesia in percutaneous nephrolitotomy. Primary outcome is the total 24 hour morphine consumption.
Detailed description
Adult patients aged 18-65 years with American Society of Anesthesiologists (ASA) physical status I-II scheduled for elective PCNL were allocated to receive either a unilateral ultrasound-guided ESPB at the T9 level with 20 mL of 0.25% bupivacaine followed by postoperative IV morphine PCA (Group ESPB ) or postoperative IV morphine PCA alone (Group C). 24 hour morphine consumption, numeric Rating Scale (NRS) pain scores, rescue analgesic requirements, sedation scores, opioid-related adverse effects, hospital stay, chronic pain, patient and surgeon satisfaction are recorded.
Interventions
PROCEDUREErector Spinae Plane Block
Erector spinae plane block is applied in longitudinal plane at T9 level.
PROCEDUREIntravenous analgesia
Inravenous morphine is administered via patient controlled analgesia device.
Sponsors
Istanbul University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Caregiver, Investigator, Outcomes Assessor)
Intervention model description
Randomized, prospective
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Elective percutaneous nephrolitotomy * American Society of Anesthesiologists (ASA) physical status I-II
Exclusion criteria
* Refusal to participate * Coagulopathy, * Infection at the block site * Allergy to local anaesthetics * Previous surgery in the block area * Severe systemic disease.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total 24-hour morphine consumption | 24 hours | Total 24-hour intravenous morphine consumption via patient controlled analgesia device |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain assessment | 24 hours | Pain assessment is evaluated using numeric rating scale (NRS 0-10; 0: no pain, 10: the worst pain imaginable) |
| Additional analgesic requirement | 24 hours | If the Numeric Rating Scale (NRS) score exceeded 4, rescue analgesia consisted of additional morphine 0.02 mg/kg, plus intravenous paracetamol 1 g. |
| Postoperative nausea and vomiting | 24 hours | Number of patients experienced postoperative nausea and vomiting . |
| Patient satisfaction | Up to 24 hours | Patient satisfaction is questioned using Likert scale:1-3 (1: dissatisfied, 2: neutral, 3: satisfied) |
| Surgeon satisfaction | Up to 24 hours | Surgeon satisfaction is questioned using Likert scale:1-3 (1: dissatisfied, 2: neutral, 3: satisfied) |
| First rescue analgesic time | 24 hours | The first time patient required rescue analgesic |
| Length of hospital stay | Up to 1 week | Length of hospital stay |
| Chronic pain | 3 months | Chronic pain is evaluated using NRS scores |
| Pruritus | 24 hours | The number of patients experienced pruritus |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORMomunat Dadashova, MD
Liv Hospital Vadi Istanbul
Outcome results
None listed