Ultrasound Guided Versus Surgical Rectus Sheath Block Versus Local Anesthesia Infiltration for Postoperative Analgesia in Patients Undergoing Total Abdominal Hysterectomy: A Randomized Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 90
- 试验地点
- 1
- 主要终点
- Total morphine consumption
研究概览
简要总结
The aim of this work is to compare the efficacy and safety of the effectiveness and safety of ultrasound-guided surgical rectus sheath block and local anesthetic infiltration for postoperative analgesia in patients undergoing total abdominal hysterectomy.
详细描述
Total abdominal hysterectomy (TAH) is a commonly performed major surgical procedure that results in substantial postoperative pain and discomfort.
Local anesthetic infiltration (LAI) at the end of surgery is one of the most common technique employed in laparotomies for postoperative analgesia.
Rectus sheath block (RSB) has been used as a part of multimodal analgesia, especially when neuraxial techniques are unsuitable.The RSB was used to achieve peri-operative relaxation of the anterior abdominal wall.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Age from 18 to 65 years old.
- •American Society of Anesthesiologists (ASA) physical status I - II.
- •Patients scheduled for elective total abdominal hysterectomy under general anesthesia.
排除标准
- •Hepatic, renal or cardiac disease.
- •Any known allergy to local anesthetic.
- •Physical or mental conditions which may vaguely measure postoperative pain following surgery.
- •History of chronic use of analgesic as nonsteroidal anti-inflammatory drugs (NSAIDs) or central nervous system (CNS) depressants as antiepileptic, and bleeding disorders.
研究组 & 干预措施
Ultrasound-guided rectus sheath block group
Patients will receive ultrasound-guided rectus sheath block (20 ml bupivacaine 0.25%) bilaterally at the end of surgery.
干预措施: Ultrasound-guided rectus sheath block (Drug)
Local anesthesia infiltration group
Patients will receive local anesthesia infiltration at the end of surgery.
干预措施: Local anesthesia infiltration (Drug)
Surgical rectus sheath block group
Patients will receive a surgical rectus sheath block (20 ml bupivacaine 0.25%) bilaterally at the time of closure.
干预措施: Surgical rectus sheath block (Drug)
结局指标
主要结局
Total morphine consumption
时间窗: 24 hours postoperatively
Rescue analgesia of morphine will be given as 3 mg bolus if the Visual Analogue Scale (VAS)\> 3 to be repeated after 30 min if pain persists until the VAS \< 4.
次要结局
- Heart rate(Till the end of surgery (Up to 4 hours))
- Mean arterial pressure(Till the end of surgery (Up to 4 hours))
- Time to the first request for the rescue analgesia(24 hours postoperatively)
- Degree of pain(24 hours postoperatively)
- Degree of patient satisfaction(24 hours postoperatively)
- Incidence of adverse events(24 hours postoperatively)
研究者
Sarah Ahmed
Lecturer of Anesthesia, Intensive care, and pain management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Ain Shams University