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Comparing Intrathecal Morphine With Erector Spina Plane Block in Open Gastrectomy Surgery

Completed
Conditions
Opioid Use
Pain Assessment Scales
Post Operative Pain
Interventions
Procedure: Regional Block Comparison
Registration Number
NCT05706285
Lead Sponsor
Marmara University
Brief Summary

Open gastrectomy causes severe postoperative pain due to wide surgical incisions, retraction of the abdominal wall and direct manipulation of the visceral organs. It leads to delayed postoperative recovery, increased medical expenses and poor surgical outcomes. Epidural analgesia, intrathecal morphine and patient-controlled analgesia are frequently used in the postoperative pain management of abdominal surgeries. Intrathecal morphine is applied as a standard protocol in many centers due to its ease of application and effective pain control. However; it has undesirable effects such as postoperative nausea-vomiting, itching and most importantly respiratory depression. Regional interfascial plane blocks, such as erector spina plane block, have recently been popular in clinical practice to provide postoperative pain control. Erector spina plane block, when placed preoperatively, is expected to reduce opioid consumption and improve outcomes. The primary implication of this study is to compare postoperative pain scores and opioid consumption. It is also aimed to compare the effectiveness of Numeric Rating Scale and Clinically Aligned Pain Assessment Tool used in postoperative pain assesment.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
63
Inclusion Criteria
  • Patients over 18 years old
  • Patients undergoing open gastrectomy surgery
Exclusion Criteria
  • Patients with solid organ dysfunction
  • Patients who receive opioid or corticosteroid medication prior to surgery
  • Patients with bleeding diathesis
  • Patients with psychiatric disorders
  • Patients who can not be contacted after surgery

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Intrathecal Morphine and Intravenous Patient Controlled AnalgesiaRegional Block Comparison-
Erector Spina Plane Block and Intravenous Patient Controlled AnalgesiaRegional Block Comparison-
Primary Outcome Measures
NameTimeMethod
Postoperative pain assessment with Clinically Aligned Pain Assessment (CAPA) Tool48 hours

CAPA tool functions as a conversation guide to gather categorical information during the course of a natural conversation. It focuses on how comfortable the patient is, whether discomfort is improving or worsening, whether the patient is able to participate in recovery activities and if pain is interfering with sleep.The clinician then codes and documents the conversation. Patient does not rate any scale or check boxes of responses.

Postoperative pain assessment with Numeric Rating Scale (NRS)48 hours

In a Numerical Rating Scale (NRS), patients are asked to choose the number between 0 and 10, that fits best to their pain intensity. Zero usually represents 'no pain at all' whereas ten represents 'the worst pain ever possible'

Comparison of postoperative opioid consumption between two groups via Patient Controlled Analgesia (PCA) device48 hours

Intravenous patient-controlled analgesia (PCA) is a system of opioid delivery that consists of an infusion pump interfaced with a timing device. Intravenous morphine consumption will be recorded via PCA device, then it will be documented in mg/kg units.

Secondary Outcome Measures
NameTimeMethod
Comparison of the frequency of treatment related complications48 hours

Bradycardia, hypotension, sedation, respiratory depression, urinary retention, itching, need for rescue analgesics.

Participant satisfaction48 hours

Whether the patient is very pleased/ satisfied/ unsatisfied/ complainant with the pain treatment will be recorded.

Trial Locations

Locations (1)

Marmara University School of Medicine

🇹🇷

Istanbul, Turkey

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