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Pain Management in Laparoscopic Cholecystectomies

Not Applicable
Completed
Conditions
Nerve Block
Interventions
Procedure: ESPB
Procedure: CONTROL
Procedure: PVB
Registration Number
NCT05837702
Lead Sponsor
Giresun University
Brief Summary

Erector spinae plane (ESP) block is a more recent method than paravertebral block (PVB) and has a lower risk of complications. The aim of this study was to compare postoperative analgesia requirements and side-effects in terms of safely reaching the maximum analgesic effect in patients.

Detailed Description

The primary aim of this study was to compare ESP block and PVB as important postoperative pain management in terms of being able to reliably reach the highest analgesic efficacy in patients who underwent laparoscopic surgery which is a frequently applied surgery. The secondary aim was to determine the incidence of postoperative nausea, vomiting and side-effects, and patient satisfaction.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
90
Inclusion Criteria
  • aged >18 years
  • patients with the American Society of Anesthesiologists (ASA) physical status I/II -who were planned to undergo laparoscopic cholecystectomy surgery
Exclusion Criteria
  • Did not provide informed consent,
  • Had any psychiatric or mental problem that prevented understanding of the informed consent form
  • They were planned to undergo emergency cholecystectomy,
  • Had any allergy or hypersensitivity to local anaesthetic,
  • Had an infection in the needle entry area
  • History of coagulopathy or the use of anticoagulants

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Erector Spinae Plane Block (ESPB)ESPBThe spinous processes of the vertebrae were marked up to T8 level. After providing antisepsis of the skin with 10% povidone iodine, the ultrasound probe was placed at T8 level parallel to the vertebral spine at T8. The transverse process (TP) and hyperechoic pleura were observed 2.5cm right lateral of the spinous process. Using the in-plane approach, the needle was placed in the caudal direction. After confirming displacement of the pleura with 0.5-1ml local anaesthetic (LA), 20ml 0.25% bupivacaine was administered for the block .
ControlCONTROLNo block has been done
Paravertebral Block (PVB)PVBAfter sterilisation of the skin with povidone iodine, the probe covered with a sterile sheath was placed 3cm lateral of the T8 spinous process. The trapezius, rhomboid major, and erector spinae muscles, and the TP of the vertebrae were visualised. The needle was placed craniocaudally within the fascial plane of the deep surface of the erector spina muscle above the bone shadow of the TP. The fluid dissemination was confirmed by raising the placement of the needle tip towards the erector spina muscle. 20ml 0.25% bupivacaine was applied to this region and the spread of local anaesthetic was observed
Primary Outcome Measures
NameTimeMethod
Total tramadol consumption24 hours postoperatively

Consumption at the end of 24 hours will be monitored by planning a 10mg bolus, a 10-minute lock-in time, through a patient-controlled analgesia device.

Secondary Outcome Measures
NameTimeMethod
Visual analog scale (VAS) at rest and when coughingat 0, 5, 10,20 minutes and 1, 2,4 , 6, 12 and 24 hours postoperatively

11-point scale where 0=no pain and 10=worst pain

Analgesic drug consumption other than tramadol24 hours postoperatively

in mg

Heart Ratepreoperative, after insufflation, after exsufflation, after extubation( 5,10,20,30 minutes)

beats /min

Mean arterial pressure (MAP)preoperative, after insufflation, after exsufflation, after extubation( 5,10,20,30 minutes)

mm-hg

Incidence of postoperative nausea & vomiting (PONV)24 hours postoperatively

Number of patients developing PONV

Shoulder pain24 hours postoperatively

Number of patients developing shoulder pain

Trial Locations

Locations (1)

Giresun University Medical School Hospital.

🇹🇷

Giresun, Merkez, Turkey

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