TO OBTAIN BEST MODE OF POST OPERATIVE ANALEGESIA FOR PATIENTS POSTED FOR LAPROSCOPIC CHOLECYSTECTOMY UNDER GENERAL ANESTHESIA

Not yet recruiting

Conditions: Calculus of gallbladder with acutecholecystitis,

Registration Number: CTRI/2022/01/039194

Lead Sponsor: VIMS and RC

Brief Summary: Surgicalpain is a universal phenomenon affecting all patients perioperatively. Apartfrom the agonizing sensory experience associated with it, acute pain has severaldeleterious effects on the physiology and the psyche of the sufferer(3).Ananticipation of these effects combined with a humanitarian urge to relievepain, play a pivotal role in provision and optimization of postoperativeanalgesia.

Laparoscopiccholecystectomy is a minimally invasive procedure which is increasinglyperformed as a day care procedure.

Thoughminimally invasive, pain experienced following laparoscopic cholecystectomy inthe immediate postoperative period may vary from moderate to severe in intensity.

Painafter laparoscopic cholecystectomy can be divided into three compartments;visceral, parietal and referred shoulder pain.

Themain sources of pain include pain from incision sites(50-70%),pnemoperitoneum(20-30%),andpost cholecystectomy wound(10-20%) within the liver causing visceral pain. Postoperativelycommon location of the pain is right upper quadrant and port sites.

Themain objective of treating the post-operative pain is to eradicate or, tominimize the pain and to speed up the healing process without any side effects.

Asa part of multi-modal analgesia, various approaches are employed for achievingsafe and effective post operative analgesia. Clinical application ofconventional perioperative analgesic modalities(eg.opoids,epidural analgesia)waslimited because of their own drawbacks.

Transversusabdominisplane block (TAP) that delivers local anaesthetic into transversusabdominisplane has been shown to reduce perioperativeopoid use in elective abdominalsurgery,including open appendicectomy,laparoscopic cholecystectomies,caesareansection and laparotomies.

Theuse of point of care ultrasonography in abdominal blocks increases the successrate and safety of the block .A variant of TAP block is (SCTAP)block where thelocal anesthetic is deposited between the transverse abdominis plane inferiorand parallel to the costal margin. The Subcostal transverses abdominisplane block provides adequate analgesia for supraumbilical surgeries because ofits greater cranial spread(T6-T10).

MULTIMODALANALGESIA-Is defined as the use of more than one pharmacological class ofanalgesic medication targeting different receptors along the pain pathway withthe goal of improving analgesia while reducing individual side effects.(1)

Multi-modalanalgesia in the peri-operative period eliminates over reliance on opoids forpain control and to reduce opoid related side effects.

Preemptivemulti-modal analgesia,combining non-opoid analgesics,Paracetamol,nonsteroidalani-inflammatory drugs or coxib and local anaesthesia has a longhistory. Local anesthesia improves postoperative pain and facilitates dischargeon the day of surgery(4).

Thusthe aim of the present study is to summarize the available best evidence andwell established practice for perioperative analgesia in elective laparoscopiccholecystectomy.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 60

Inclusion Criteria

ASA-I & II PTS UNDERGOING LAP CHOLECYSTECTOMY UNDER GA.

Exclusion Criteria

H/0 ALLERGY TO TEST DRUGS 2.CONVERSION TO OPEN CHOLECYSTECTOMY 3 BRONCHIAL ASTHMA.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Adequate intraoperative and post operative analgesia achieved in laproscopic cholecystectomy patients	total rescue analgesia asked in 24 hours. \| first rescue analgesia asked within how many hours by each group.

Secondary Outcome Measures

Name	Time	Method
hemodynamic changes during intraoperative period of the surgery and post op rescue analgesia used.	post op rescue analgesia asked ranges from within 1 hour to 8 hours after surgery

Trial Locations

Locations (1): VIMS and RC
🇮🇳
Bangalore, KARNATAKA, India
VIMS and RC
🇮🇳Bangalore, KARNATAKA, India
Deepika K C
Principal investigator
9916546045
deepukc25@gmail.com