Comparative Study Between the Analgesic Effect of Erector Spinae Plane Block and Transversus Abdominis Plane Block After Elective Cesarean Section
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 60
- 试验地点
- 3
- 主要终点
- duration of analgesia of the two blocks
研究概览
简要总结
The aim of work is to assess and compare the analgesic efficacy of bilateral erector spinae plane block with that of bilateral transversus abdominis plane block after elective cesarean section.
详细描述
Inclusion criteria:
- Parturients aged 18 - 40 years with American Society of Anesthesiologists physical status І or ІІ, scheduled for elective cesarean section via a low transverse abdominal incision (Pfannenstiel) and receiving intrathecal anesthesia without sedation.
Exclusion criteria:
- Patient refusal.
- Contraindications to regional anesthesia.
- Known allergy to the study drugs.
- Severe cardiovascular, renal or hepatic diseases.
- Bleeding disorders.
- Local infection.
Participants will be randomly divided into two groups:
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 (Outcomes Assessor)
盲法说明
Single-blind
入排标准
- 年龄范围
- 18 Years 至 40 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •aged 18 - 40 years
- •American Society of Anesthesiologists physical status ІІ, scheduled for elective cesarean section via a low transverse abdominal incision (Pfannenstiel) and receiving intrathecal anesthesia without sedation.
排除标准
- •Patient refusal.
- •Contraindications to regional anesthesia.
- •Known allergy to the study drugs.
- •Severe cardiovascular, renal or hepatic diseases.
- •Bleeding disorders.
- •Local infection.
研究组 & 干预措施
ES Erector Spinae Plane Block
bilateral ESP block at the level of T9 by a linear ultrasound (US) transducer (Phillips Saronno Italy) placed vertically 3cm lateral to the midline to visualize the back muscles superior to the transverse process.
A 22-G short bevel needle (spinocan, B.Braun, melsungen AG, Germany) will be inserted in cranial-caudal direction until it make contact with the transverse process. Confirmation of the correct position of the tip of the needle is by injection of 1 ml saline causing hydrodisscetion between the erector spinae muscle and the transverse process. After careful aspiration to exclude vascular puncture, 20 ml 0.25 % bupivacaine is injected.The same procedure is done on the other side of the back.
干预措施: ESPB and TAP block (Procedure)
TAP Transversus Abdominis Plane Block
bilateral TAP block: while the patient in the supine position, a linear ultrasound (US) transducer (Phillips Saronno Italy) is placed transversally on the anterolateral abdominal wall in the midaxillary line between the iliac crest and the costal margin identifying external oblique, internal oblique and transversus abdominis muscles. The TAP is between internal oblique and transversus abdominis.
A 22-G needle (spinocan, B.Braun, melsungen AG, Germany) is introduced anteriorly to the transducer and advanced to reach the TAP between internal oblique muscle and transversus abdominis muscle. After careful aspiration to exclude vascular puncture, 20 ml 0.25 % bupivacaine is injected causing an elliptical separation of the two muscles. The same procedure is done on the other side.
干预措施: ESPB and TAP block (Procedure)
结局指标
主要结局
duration of analgesia of the two blocks
时间窗: 24 hours
time
次要结局
- Visual analogue scale(24 hours)
- the first request to analgesia(24 hours)
- total analgesic consumption(24 hours)
- Visual analogue scale(immediatiy in pacu)
- Visual analogue scale(4 hours)
- Visual analogue scale(8 hours)
- Visual analogue scale(12 hours)
研究者
Mohamed Ahmed Hamed
Anesthesia lecturer
Fayoum University