Erector Spinae Plane Block Versus Paravertebral Block Versus Quadratus Lumborum Block on Postoperative Analgesia After Pelvi-ureteric Surgeries: A Randomized Double-Blinded, Non-inferiority Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 90
- 试验地点
- 2
- 主要终点
- The total postoperative morphine consumption
研究概览
简要总结
The aim of this study is to compare the analgesic efficacy of erector spinae plane block versus thoracic paravertebral block versus quadratus lumborum block on postoperative analgesia after pelvi-ureteric surgeries.
详细描述
Opioid-based analgesia plays a significant role in the control of postsurgical pain; however, use of opioid may lead to significant side effects (e.g., nausea and vomiting) and adverse events (e.g. respiratory depression), which may be associated with significantly longer hospital stays and higher hospital costs in the postsurgical setting .
Thoracic paravertebral block (TPVB) is a classic trunk block with definite analgesic effect for both somatic and visceral pain.
Quadratus Lumborum block (QLB) is a widely used regional anesthesia technique as well. It has been used for reducing postoperative pain after cesarean section, laparotomy or laparoscopic procedure and hip surgery.
Erector spinae plane block (ESPB) is a novel inter-fascial plane block first introduced by Forero et al. in 2016 , providing wide-ranging analgesia in lung surgery, laparoscopy, mastectomy, and pediatric surgery. The proposed mechanism of ESPB is that distribution of local anesthetic solution spreads into the para-vertebral space and epidural space, which then blocks the dorsal, ventral, and traffic branches of spinal nerve.
ESPB, TPVB and QLB III have been shown to improve analgesic outcome after urological surgeries.
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
- 21 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 18-65 years
- •Both genders
- •American Society of Anesthesiologists (ASA) physical status I-III
- •Undergoing elective pelvi-ureteric surgeries.
排除标准
- •Body Mass Index > 30 kg/m
- •Contraindication of deep nerve block such as allergic to anesthetic drug, coagulation disorder, and infection at the injection site.
- •Chronic opioids dependence or chronic pain over 3 months.
- •Use of medication such as gabapentin-pregabalin could affect pain perception.
- •Unable to communicate preoperatively due to severe dementia, language barrier, or neuropsychiatric disorder.
- •Unable to perform nerve block procedure due to difficult anatomy through ultrasound scan.
结局指标
主要结局
The total postoperative morphine consumption
时间窗: 48 hours postoperatively
Total amount of rescue analgesic in the first 48 hours postoperative will be measured.
次要结局
- Patients' satisfaction after surgery.(48 hours Postoperatively)
- Access time of first analgesic(48 hours Postoperatively)
- Access post-operative pain scores(48 hours Postoperatively)
研究者
Mohamed Fouad Algyar
Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine
Kafrelsheikh University