Ultrasound-Guided Erector Spinae Plane Block in Radical Cystectomy: A Randomized Controlled Study
Overview
- Phase
- Not Applicable
- Intervention
- Bupivacain 25% (Erector Spinae Plane Block)
- Conditions
- Erector Spinae Plane Block
- Sponsor
- Kafrelsheikh University
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Total morphine consumption
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
The aim of this research is to study and compare the efficacy and safety of bilateral single injection erector spinae plane block (ESPB) compared with intravenous patient-controlled analgesia (IV-PCA) in managing postoperative pain after radical cystectomy.
Detailed Description
Radical cystectomy (RC) is one of the most challenging surgical techniques in Urology. Acute postsurgical pain is frequently detrimental in a patient's recovery and quality of life. Intravenous patient-controlled analgesia (IV-PCA) is one of the most commonly used strategies in clinical practice for controlling postoperative pain. It involves continuous administration of a programmed dose of analgesics, while also allowing patients to receive additional, need-based doses. One such avenue is the erector spinae plane block (ESPB), a novel analgesic technique first described in 2016 by Forero et al. Although the mechanism of action of the ESPB is unknown, a proposed mechanism is via blockade of the dorsal and ventral rami of thoracic/lumbar spinal nerves. ESPB has been used as analgesia in rib fractures and other thoracic procedures as well as in abdominal surgeries.
Investigators
Tarek Ezzat Abd El Galil
Assistant Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Kafrelsheikh University, Egypt
Kafrelsheikh University
Eligibility Criteria
Inclusion Criteria
- •Age of the patient between 21 to 65 years.
- •Both sexes.
- •Body mass index (BMI): 20 - 40 kg/m
- •American Society of Anesthesiologists (ASA) physical status II-III.
- •Elective radical cystectomy.
Exclusion Criteria
- •Patient refusal.
- •Psychiatric and cognitive disorders.
- •Local infection at the site of injection.
- •Allergy to study medications.
- •Anatomic abnormalities.
- •Inability to comprehend or participate in pain scoring system.
Arms & Interventions
Erector Spinae Plane Block group
Patients received ultrasound guided bilateral single shot erector spinae pane block (ESPB) at Th10 level with 20 mL 0.25% bupivacaine after the end of surgery.
Intervention: Bupivacain 25% (Erector Spinae Plane Block)
Intravenous patient-controlled analgesia group
Patients received Intravenous patient-controlled analgesia (IV-PCA) by morphine
Intervention: Morphine (Intravenous patient-controlled analgesia)
Outcomes
Primary Outcomes
Total morphine consumption
Time Frame: 48 hours postoperatively
Bolus dose of IV morphine (3mg) was provided as a rescue analgesia when the numeric rating scale (NRS) ≥ 4.
Secondary Outcomes
- Degree of pain(48 hours postoperatively)
- Incidence of side effects(48 hours postoperatively)
- The time of first rescue analgesia(48 hours postoperatively)