Ultrasound-Guided External Oblique Intercostal Plane Block Versus Subcostal Transversus Abdominis Plane Block For Perioperative Analgesia in Laparoscopic Sleeve Gastrectomy
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 70
- 试验地点
- 1
- 主要终点
- Total morphine consumption
研究概览
简要总结
This study aims to compare the analgesic efficacy, duration of analgesia, and overall opioid consumption between the external oblique intercostal plane (EOIP) block and subcostal transversus abdominis plane (TAP) block in patients undergoing laparoscopic sleeve gastrectomy.
详细描述
Postoperative pain management is a critical aspect of enhanced recovery after surgery (ERAS) protocols, particularly in laparoscopic bariatric procedures such as sleeve gastrectomy.
Among the ultrasound-guided abdominal wall blocks, the transversus abdominis plane (TAP) block and its subcostal variant have demonstrated efficacy for upper abdominal surgeries. The subcostal TAP block provides analgesia for the T6-T9 dermatomes, covering incisions in upper abdominal procedures like laparoscopic cholecystectomy and bariatric surgery.
The external oblique intercostal plane (EOIP) block is a relatively new fascial plane block that targets the intercostal nerves lying between the external oblique and intercostal muscles.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age from 18 to 65 years.
- •Both genders.
- •American Society of Anesthesiologists (ASA) class I or II
- •Body mass index (BMI) between 30-50 kg/m².
- •Scheduled for elective laparoscopic sleeve gastrectomy under general anesthesia.
- •Written informed consent from patients or surrogate decision makers.
排除标准
- •Patient refusal.
- •Allergy to local anesthetics.
- •Coagulation disorders or anticoagulant therapy.
- •Local infection or scar at the injection site.
- •Severe hepatic or renal dysfunction.
- •Chronic opioid use or psychiatric illness interfering with pain assessment.
- •Conversion to open surgery or intraoperative complications requiring re-exploration.
研究组 & 干预措施
EOIP Group (Group A )
Patients will receive an ultrasound-guided bilateral external oblique intercostal plane (EOIP) block using 20 mL of 0.25% bupivacaine in each side after induction of anesthesia and prior to surgical incision.
干预措施: External oblique intercostal plane block (Other)
Subcostal TAP Group (Group T)
Patients will receive a bilateral subcostal transversus abdominis plane (TAP) block using 20 mL of 0.25% bupivacaine in each side, under ultrasound guidance and identical conditions.
干预措施: Subcostal transversus abdominis plane block (Other)
结局指标
主要结局
Total morphine consumption
时间窗: 24 hours postoperatively
Patient-controlled analgesia (PCA) using intravenous morphine (1 mg bolus, 10-minute lockout) will be available for rescue analgesia when visual analogue score ( VAS ) \> 3.
次要结局
- Time to first rescue analgesia(24 hours postoperatively)
- Degree of pain(24 hours postoperatively)
- Heart rate(Till the end of surgery (Up to two hours))
- Mean arterial blood pressure(Till the end of surgery (Up to two hours))
- Incidence of postoperative nausea and vomiting(24 hours postoperatively)
- Block-related complications(24 hours postoperatively)
- Degree of patient satisfaction(24 hours postoperatively)
研究者
Ahmed Alaa El din Ali
Resident of Anesthesiology, Egypt.
Benha University