A patient with morbid obesity, BMI more than 35 kg/m2 morbid obesity, ultrasound-guided rectus sheath block, laparoscopic sleeve gastrectomy, analgesic effect
Conditions
Interventions
ultrasound-guided rectus sheath block with 1% lidocaine with adrenaline (1:400000) + bupivacaine 0.25% 20 ml with dexamethasone 10 mg will be injected after a negative aspiration test to each side,Sur
Experimental Procedure/Surgery,Experimental Procedure/Surgery
ultrasound-guided rectus sheath block,standard of care
Sponsors
no funding apply to this study
Eligibility
Sex/Gender
All
Age
20 Years to 65 Years
Inclusion criteria
Inclusion criteria: 1. A patient with morbid obesity, BMI equal to or greater than 35 kg/m2 2. Patients aged between 20 and 65 years 3. American Society of Anesthesia (ASA) physical status ll to lll 4. Scheduled for elective laparoscopic gastrectomy surgery
Exclusion criteria
Exclusion criteria: 1. Patient reject to participated 2. Patients with known allergies to any of the study drugs (local anesthetics, opioids, NSAIDs) 2. Recent use of opioid drugs 3. Underlying chronic kidney disease, liver cirrhosis, major cardiac disease, or pre-existing neurological deficits
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| intraoperative opioid consumption (fentanyl)) During procedure total intraoperative fentanyl (mcg)consumption | — |
Secondary
| Measure | Time frame |
|---|---|
| The first post operative 24 hours morphine (mg) consumption 24 hours post operative pain The first post operative 24 hours morphine (mg) consumption,Pain intensity Pain intensity on PACU arrival, 15 minutes, 30 minutes, 45 minutes and one hour after PACU admission , pain intensity upon arrival to the ward and at 6, 12, 24, 36 and 48 hours postoperatively numeric rating scale at PACU and ward ,Time to first rescue analgesia 24 hours postoperatively time to first rescue dose of opioid (morphine)),Postoperative functional recovery After surgery until discharge length of hospital stay, time to 1st flatus or stool passage, time to 1st feeding, nausea and vomiting,patient satisfaction score At ward on the day after surgery 10 maximum satisfied 0 unsatisfied,The dermatomal sensory block At recovery room after fully regaining consciousness using cold stimulation (ice cubes) by a blinded assessor in each dermatome distribution from T6-T12 in midline of abdomen,Time from operation to ambulation At ward out of bed,Opioid-related side effects 24 hours postoperatively nausea, vomiting, itching, hypotension, respiratory depression, and urinary retention after off urine catheter,Block duration (hours) 24 hours postoperatively the time to feel pain in the surgical area (upper abdomen) ,The safety of the blocks During procedure vascular puncture, bleeding, hematoma, local anesthetic systemic toxicity (LAST) or peritoneal puncture | — |
Countries
Thailand
Contacts
Public ContactPanuwat Lapisatepun
Department of anesthesiology,chiangmai university
Outcome results
None listed