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Analgesic Efficacy of Adding Dexmedetomidine to Erector Spinae Plane Block Versus Subcostal Transverse Abdominis Plane Block in Laparoscopic Cholecystectomy

Not Applicable
Completed
Conditions
Analgesic Efficacy
Dexmedetomidine
Erector Spinae Plane Block
Subcostal Transverse Abdominis Plane Block
Laparoscopic Cholecystectomy
Registration Number
NCT07075913
Lead Sponsor
Kafrelsheikh University
Brief Summary

Our scientific work aimed to evaluate the analgesic efficacy of dexmedetomidine as an adjuvant to erector spinae plane block versus subcostal transverse abdominis plane block in patients undergoing laparoscopic cholecystectomy.

Detailed Description

Laparoscopic cholecystectomy (LC) is the most commonly performed surgical procedure for the management of cholelithiasis. Acute pain after LC consists of somatic, parietal, and referred pain caused by trocar insertion, gall bladder resection, carbon dioxide insufflation, and other factors.

The subcostal transverse abdominis plane (SCTAP) block is the deposition of local anesthetic in the transverse abdominis plane inferior and parallel to the costal margin.

Ultrasound-guided erector spinae plane block (ESPB) is a popular, interfascial regional technique initially described for managing thoracic neuropathic pain.

Dexmedetomidine is an alpha-2 adrenergic receptor agonist that has been the focus of interest due to its sedative, analgesic, perioperative sympatholytic, and cardiovascular-stabilizing effects, resulting in reduced anesthetic requirements.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Age from 20 to 60 years.
  • Both sexes.
  • American Society of Anesthesiologists (ASA) physical status I and II.
  • Patients were planned to undergo laparoscopic cholecystectomy.
Exclusion Criteria
  • Patient's refusal to participate in the study.
  • ASA III, IV.
  • History of clinically significant cardiac, hepatic, renal, respiratory or neurological disease.
  • Coagulopathy and bleeding disorders.
  • Known allergy to any drug included in the study.
  • Systemic or local infection at the puncture site.
  • Body mass index (BMI) >35 (kg/m2).
  • Failed technique.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Total dose of morphine consumption24 hours postoperatively

If the Visual analogue scale (VAS) is ≥ 3, IV morphine was given as a bolus of 2 mg (body weight \< or = 60 kg) or 3 mg (body weight \> 60 kg) with 5 minutes' lockout interval.

Secondary Outcome Measures
NameTimeMethod
Heart rate24 hours postoperatively

Heart rate was recorded at baseline, after injection then every 30 minutes till the end of surgery and after surgery at 0, 2, 4, 6, 8, 12, 16 and 24 h.

Mean arterial pressure24 hours postoperatively

Mean arterial pressure was recorded at baseline, after injection then every 30 minutes till the end of surgery and after surgery at 0, 2, 4, 6, 8, 12, 16 and 24 h.

Intraoperative opioid consumptionIntraoperatively

Intraoperative opioid consumption was recorded.

Time to first rescue analgesia24 hours postoperatively

Time to first rescue analgesia was recorded from the end of surgery till first dose of morphine administrated.

Degree of pain24 hours postoperatively

Visual analogue scale (VAS) was assessed after surgery at 0, 2, 4, 6, 8, 12, 16, 18, and 24 h \[where (0 = no pain and 10 = severe pain)\].

Incidence of complications24 hours postoperatively

Incidence of complications such as pneumothorax, local anesthetic systemic toxicity (LAST), bradycardia, hypotension, nausea, vomiting, and failed block were recorded.

Patient satisfaction24 hours postoperatively

Degree of patient satisfaction will be assessed on a 3-point scale; (1= Unsatisfied, 2= neither satisfied nor unsatisfied, 3= satisfied).

Trial Locations

Locations (1)

Kafrelsheikh University

🇪🇬

Kafr Ash Shaykh, Kafrelsheikh, Egypt

Kafrelsheikh University
🇪🇬Kafr Ash Shaykh, Kafrelsheikh, Egypt

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