Role of Dexamethasone for Erector Spinae Plane Block in Patients Undergoing Total Abdominal Hysterectomy
- Conditions
- Postoperative Pain
- Interventions
- Registration Number
- NCT03769818
- Lead Sponsor
- Aswan University Hospital
- Brief Summary
The aim to study the efficacy of bupivacaine 0.25% with dexamethasone and that of bupivacaine 0.25% alone for erector spinae plane block for postoperative analgesia in patients undergoing total abdominal hysterectomy Group 1: bupivacaine 0.25% + dexamethasone 8 mg
* Group 2: bupivacaine 0.25%
* Group3: control group A prospective Randomized Interventional double-blind study.
- Detailed Description
Optimal dynamic analgesia is recognized as the key to enhanced recovery following open abdominal surgery. In the last decade, there has been a significant shift away from thoracic epidural analgesia (TEA) that has been long considered as the gold standard. Various techniques have tried to replicate the analgesic efficacy of TEA. They include transversus abdominis plane analgesia (TAP), rectus sheath analgesia (RS), wound infusion analgesia (WI) and trans muscular quadratus lumborum analgesia. However, each of these techniques has specific limitations that prevent them from being the analgesic technique of choice for all open abdominal surgeries. Chin et al first described the erector spinae plane (ESP) block for providing analgesia following ventral hernia repair. The unique feature of the ultrasound-guided truncal blocks is that in all of these techniques, in contrast to peripheral nerve blocks, no nerve or plexus needs to be identified: Local anesthesia (LA) is injected in a particular muscle plane, in which the injectate spreads and reaches the intended nerves. This simple mechanism has made delivery of nerve blocks easy and versatile.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 150
- Women ranging age between 30-60 years a who undergoing elective total abdominal hysterectomy
- Participants had known sensitivity to bupivacaine
- Participants had difficulty in intubation
- Participants were on chronic pain medication or already on long-term opioids
- Participants smokers
- Participants with disabilities who were unable to communicate pain levels
- refuse to consent
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description bupivacaine and dexamethasone bupivacaine Bilateral ESP block with 20 ml of 0.25% bupivacaine + 4 mg/kg dexamethasone diluted with isotonic saline. bupivacaine and dexamethasone dexamethasone Bilateral ESP block with 20 ml of 0.25% bupivacaine + 4 mg/kg dexamethasone diluted with isotonic saline. bupivacaine and placebo to dexamethasone bupivacaine Bilateral ESP block with 20 ml of 0.25% bupivacaine bilaterally plus placebo to dexamethasone bupivacaine and placebo to dexamethasone placebo to dexamethasone Bilateral ESP block with 20 ml of 0.25% bupivacaine bilaterally plus placebo to dexamethasone control group placebo to dexamethasone Bilateral ESP block with placebo to bupivacaine bilaterally plus placebo to dexamethasone control group placebo to bupivacaine Bilateral ESP block with placebo to bupivacaine bilaterally plus placebo to dexamethasone
- Primary Outcome Measures
Name Time Method Visual analog score for pain during movement 24 hours post operative movement-evoked pain measurements ranging from 0 to 10, where 0 no pain and 10 maximum pain
- Secondary Outcome Measures
Name Time Method number of days patients stay in hospital 4 weeks calculation of number of days patients stay in hospital
Visual analog score for pain during rest 24 hours postoperative ranging from 0 to 10, where 0 no pain and 10 maximum pain
number of patients need Fentanyl consumption 24 hours postoperative calculation of the number of patients need Fentanyl consumption
Trial Locations
- Locations (1)
Aswan University
🇪🇬Aswan, Egypt