Analgesic Efficacy of Erector Spinae Plane Block vs External Oblique Intercostal Plane Block in Subcostal Cancer Surgeries: A Randomized Controlled Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 70
- 试验地点
- 1
- 主要终点
- Total amount of morphine consumption
研究概览
简要总结
This study aims to evaluate the impact of ultrasound-guided erector spinae plane block compared to ultrasound-guided external oblique intercostal plane block regarding management of postoperative acute pain in patients undergoing above Umbilical surgical procedure.
详细描述
Subcostal incisions in cancer surgeries as in hepatectomy and nephrectomy are a cause of severe pain and can lead to significant respiratory impairment. Regional anesthesia of the trunk and abdominal wall is usually centered on epidural analgesia.
Erector spinae plane block (ESPB) is the deposition of local anesthetic (LA) in the interfascial plane at the paraspinal region. It provides effective visceral and somatic analgesia.
The recently described external oblique intercostal plane block (EOIPB) is a simple, effective, and convenient block, particularly in the context of morbid obesity, at which local anesthetic (LA) is deposited in the interfacial plane deep to external oblique muscle at the sixth intercostal space. It provides a blockade of the thoracoabdominal nerves at the level of T6 to T10.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Single (Participant)
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 (18-65) Years.
- •Both sexes.
- •Body mass index (BMI): (20-40) kg/m
- •American Society of Anesthesiology (ASA) physical status II, III.
- •Type of surgery; unilateral subcostal incision in hepatectomy and nephrectomy.
排除标准
- •Patient refusal.
- •Subcostal incisions that are crossing the midline or midline incision.
- •Age <18 years or >65 years
- •BMI <20 kg/m2 and >40 kg/m2
- •Known sensitivity or contraindication to drugs used in the study
- •Contraindication to regional anesthesia e.g. local infection at the site of introduction, pre-existing peripheral neuropathies, and coagulopathy.
- •Pregnancy.
- •Physical status ASA IV
- •patients on chronic analgesic therapy (daily morphine ≥30 mg or equivalent dose of other opioids or tramadol or any medication for neuropathic pain)
- •patients with a history of drug abuse
- •patients with neuropsychiatric diseases; patients with a history of chronic pain syndromes that may enhance sensitivity to pain, for example, fibromyalgia
- •All patients who are going to have severe intra- or post-operative bleeding or will require postoperative mechanical ventilation are also excluded from the study.
研究组 & 干预措施
Erector Spinae Plane Block
Patients will receive an ultrasound-guided erector spinae plane block with the injection of 30 ml bupivacaine 0.25% after induction of general anesthesia.
干预措施: Erector Spinae Plane Block (Drug)
External Oblique Intercostal Plane Block
Patients will receive an ultrasound-guided external oblique intercostal plan block Intraoperative with the injection of 30 ml bupivacaine 0.25% after induction of general anesthesia.
干预措施: External Oblique Intercostal Plane Block (Drug)
结局指标
主要结局
Total amount of morphine consumption
时间窗: 24 hours postoperatively
Rescue analgesia will be provided in the form of IV morphine 3 mg boluses if the patient indicates Numeric Pain Rating Scale ≥ 4. The total amount of morphine given in 24 hours will be recorded for the two groups. A maximum dose of 0.5 mg/kg/24hours of morphine is allowed.
次要结局
- Time of first rescue analgesia(24 hours postoperatively)
- Mean arterial blood pressure(Till the end of surgery)
- Complications(24 hours postoperatively)
- Total amount of intraoperative fentanyl consumption(Intraoperatively)
- Heart rate(Till the end of surgery)
- Patient satisfaction(24 hours postoperatively)
研究者
Osama Sayed Mohamed Ibrahim
Assistant Lecturer of Anesthesiology, Intensive Care Unit and Pain Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
National Cancer Institute, Egypt