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Postoperative Analgesia of TAP Block for Laparoscopic Sleeve Gastrectomy

Not Applicable
Recruiting
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
Inclusion Criteria
  • Age 20-60 years
  • ASA Ι-ΙΙ
  • BMI >35
Exclusion Criteria
  • Patient refusal.
  • Allergy to study drugs.
  • Infection at site of injection.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
TAP groupsubcostal TAP blockpatients candidate for laparoscopic sleeve gastrectomy to receive GA and subcostal TAP block to control postoperative pain and minimize opioid consumption
Primary Outcome Measures
NameTimeMethod
Postoperative pain control9 months

by using VAS score

Secondary Outcome Measures
NameTimeMethod
postoperative nausea and vomiting9 months

recording incidence, frequency and severity

postoperative 24 hour opioid consumption9 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

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