Respiratory Effects of Rectus Sheath Block in Patients Undergoing Major Upper Abdominal Surgery.
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- Assiut University
- Enrollment
- 60
- Locations
- 2
- Primary Endpoint
- Diaphragmatic inspiratory amplitude during quiet/deep breathing (DIA)/cm
Study Overview
Brief Summary
This study will be undertaken to investigate the respiratory and analgesic effects of ultrasound guided rectus sheath block analgesia after elective abdominal surgery with midline incision.
Detailed Description
A major proportion of pain experienced by patients undergoing abdominal surgeries is due to somatic pain signals derived from the abdominal wall. The central portion of anterior abdominal wall components (skin, muscles and parietal peritoneum) is innervated by sensory neurons branching from the anterior rami of spinal nerves T7 to T1. These neurons lie between the rectus abdominis muscle and posterior rectus sheath, and pierce the rectus muscle close to the midline. The tendinous intersections of the rectus muscle do not fuse with the posterior rectus sheath, thereby allowing the injectate to spread cephalo-caudally within this potential space. Rectus sheath (RS) block has been described for any midline abdominal incisions (epigastric and umbilical hernia repairs). As visceral pain becomes attenuated by the 2nd postoperative day, rectus sheath block can also be administered for midline laparotomy.
However, the effects of rectus sheath block analgesia on the respiratory function after abdominal surgery with midline incisions are still under investigation.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Double (Participant, Outcomes Assessor)
Masking Description
double blinded
Eligibility Criteria
- Ages
- 18 Years to 50 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age: 18-50 years.
- •Sex: both males and females.
- •BMI< 30kg/m
- •ASA physical status: 1, II and III.
- •Elective abdominal surgery with midline incisions.
Exclusion Criteria
- •Patient refusal.
- •Infection at injection site
- •Coagulation disorders.
- •Allergy to study medications.
- •Pregnancy.
- •Respiratory tract infection within the last 2 weeks.
- •Urgent abdominal surgery
Outcomes
Primary Outcomes
Diaphragmatic inspiratory amplitude during quiet/deep breathing (DIA)/cm
Time Frame: 24 hours Postoperative
The ultrasonic measurements of diaphragmatic motion will be attained at the posterior surface of the diaphragm. From the tracings on M-mode, the distance between echogenic lines (DIA) in centimeters and diaphragmatic inspiratory/expiratory velocity in centimeters/second during quiet, deep, and sniff breathing will be measured on the frozen images.
Secondary Outcomes
- Verbal Rating Scale(24 hours Postoperatively)
- Forced Vital Capacity/L(24 hours Postoperatively)
Investigators
Noha Yahia Mohammd El-hagagy
Lecturer of anesthesia and intensive care, faculty of medicine, Assiut university.
Assiut University