Postoperative Analgesia of TAP Block for Laparoscopic Sleeve Gastrectomy
- Conditions
- Postoperative Pain
- Interventions
- Other: subcostal TAP block
- Registration Number
- NCT06156657
- Lead Sponsor
- Al-Azhar University
- Brief Summary
many methods were considered to control postoperative pain in laparoscopic bariatic surgery including non steroidal anti-inflammatory drugs, opioids and neuraxial block
but subcostal (TAP) block has provided good analgesic effect when used as a part of multimodal analgesia in bariatric surgery due to lack of visceral block
- Detailed Description
Since long time opioid have been used to control postoperative pain in bariatric surgery However, an increasing awareness of opioid-related adverse events, including respiratory depression, paralytic ileums, and sedation, constipation has led to a shift towards utilizing opioid-sparing techniques for postoperative analgesia As neuroaxial block and ultrasound guided nerve blocks
As the transverse abdominis plane (TAP) block which is of increasing interest nowadays (Basaran B, et al 2015)
The ultrasound-guided oblique SCTAP block, first described by Hebbard et al., has the potential to provide analgesia for both upper and lower abdominal surgery. There is a growing consensus that the SCTAP block provides better analgesia for upper abdominal incisions
The TAP block via various approaches provides some advantages over neuraxial anesthesia (Ganapathy Set al 2015). For example, TAP blocks are associated with a lower use of intraoperative phenylephrine and a lesser degree of intraoperative blood pressure changes. The SCTAP block may be utilized in cases in which neuraxial anesthesia is contraindicated, such as patients with coagulation issues or infection at the epidural puncture site. Although the SCTAP block provides sensory blockade of the abdominal wall, it is lacking in coverage of visceral pain (Lissauer J,et al 2014).
The lack of visceral pain analgesia may require the use of additional methods of postoperative pain control such as intravenous opioids or non-narcotic analgesics.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 100
- Age 20-60 years
- ASA Ι-ΙΙ
- BMI >35
- Patient refusal.
- Allergy to study drugs.
- Infection at site of injection.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description TAP group subcostal TAP block patients candidate for laparoscopic sleeve gastrectomy to receive GA and subcostal TAP block to control postoperative pain and minimize opioid consumption
- Primary Outcome Measures
Name Time Method Postoperative pain control 9 months by using VAS score
- Secondary Outcome Measures
Name Time Method postoperative nausea and vomiting 9 months recording incidence, frequency and severity
postoperative 24 hour opioid consumption 9 months collecting total doses of opioids consumed in the first 24 hours postoperative in cmparison to the other group
Trial Locations
- Locations (1)
Al Azhar University
🇪🇬Cairo, Naser City, Egypt