Deep Neuromuscular Block With Low Pressure Pneumoperitoneum in Laparoscopic Abdominal Surgeries
- Conditions
- PneumoperitoneumLaparoscopic Abdominal SurgeriesDeep Neuromuscular BlockLow Pressure
- Interventions
- Other: Moderate neuromuscular blockOther: Deep neuromuscular block
- Registration Number
- NCT06242262
- Lead Sponsor
- Tanta University
- Brief Summary
The aim of this study is to evaluate the effect of deep neuromuscular block on postoperative pain, duration of surgery, quality of surgical field, length of recovery room stays, Total amount of rescue analgesic, postoperative nausea/vomiting, and length of hospital stay.
- Detailed Description
Acute-pain management in surgery patients is accompanied by an array of negative consequences, including increased morbidity, impaired physical function, and quality of life, slowed recovery, prolonged opioid use during and after hospitalization, and increased cost of care.
Reducing pneumo-peritoneum (PP) is one technique for reducing postoperative pain. The effect of low PP on postoperative pain remains a controversial topic with other studies reporting no difference in postoperative pain levels between the Two pressures.
Deep neuromuscular block (DNMB) in abdominal surgeries is associated with various advantages, such as lower abdominal pressure, lower pain and rescue opioid consumption, as well as less bleeding. DNMB may facilitate the use of reduced insufflation pressure without compromising the surgical field of vision. However, its usage is limited due to a lack of predictable and rapid recovery with conventional NMB antagonists (neostigmine) or spontaneous recovery
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 44
- Age 18 to 65 years old.
- Both sexes.
- American Society of Anesthesiologists (ASA) physical status I-III.
- Patients scheduled for laparoscopic abdominal surgery.
- Known allergies to cis-atracurium or neostigmine.
- Contraindications to the use of neostigmine, such as bronchial asthma, glaucoma, myocardial ischemia, and epilepsy.
- History of neuromuscular, renal, or hepatic disease; previous abdominal surgery.
- Treatment with drugs known to affect neuromuscular function.
- Preoperative hyperalgesia.
- Peripheral neuropathy is caused by diabetes.
- History of chronic analgesics treatment, drug, or alcohol abuse.
- Body mass index (BMI) > 35 kg/m2.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Moderate neuromuscular block Moderate neuromuscular block Patients will receive moderate neuromuscular block by using cis-atracurium. Deep neuromuscular block Deep neuromuscular block Patients will receive deep neuromuscular block by using cis-atracurium
- Primary Outcome Measures
Name Time Method The degree of pain 48 hours postoperatively The degree of pain will be evaluated using the numerical rating scale (NRS) from (0 to 10), zero means no pain and ten means the worst pain. It will be measured at PACU, 1h, 2h. 4hr, 6h, 8h, 12h, 18h, 24h, 36h and 48h postoperative.
- Secondary Outcome Measures
Name Time Method The degree of Patient satisfaction 48 hours postoperatively The degree of patient satisfaction will be assessed on a 5-point scale: (0= extremely dissatisfied, 1= unsatisfied, 2= neither satisfied nor unsatisfied, 3= satisfied), 4= extremely satisfied).
Total opioid consumption in 1st 48h 48 hours postoperatively A standardized analgesic regimen will be prescribed in the post-operative period. All patients will receive paracetamol 1 gm every 6 h as routine analgesia. If numerical rating scale (NRS) is more than 3, intravenous morphine 3mg will be administered as rescue analgesia.
Time of first analgesic 48 hours postoperatively Time of first analgesic will be measured from the end of surgery till first dose of morphine administrated. If numerical rating scale (NRS) is more than 3, intravenous morphine 3mg will be administered as rescue analgesia.
Trial Locations
- Locations (1)
Tanta University
🇪🇬Tanta, El-Gharbia, Egypt