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ESP Block VS Intrathecal Opioid After Laparoscopic Colorectal Surgery

Phase 1
Terminated
Conditions
Surgery
Interventions
Drug: ESP Block
Drug: IT Injection
Registration Number
NCT05257941
Lead Sponsor
Indiana University
Brief Summary

This study is being done to compare 2 types of pain control methods and determine which is more effective postoperatively for laparoscopic colorectal surgery. Group 1 will receive an intrathecal (IT) injection in the back in which a small dose duramorph and bupivacaine will be placed into the spinal fluid. Group 2 will receive an erector spinae plane (ESP) block in which bupivacaine and decadron are injected near the nerves under a muscle in the back.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
116
Inclusion Criteria
  • Patients undergoing an elective laparoscopic colorectal procedure at Indiana University Hospital or Methodist Hospital
  • ASA Class 1, 2, 3 (American Society of Anesthesiologists physical status classification system)
  • Age 18 to 80 years (male or female)
  • BMI < 40kg/m2
  • Desires regional anesthesia for postoperative pain control
Exclusion Criteria
  • Any contraindication for neuraxial analgesia or ESP block procedure

    • Contraindications for neuraxial analgesia include: Elevated intracranial pressure (except in cases of pseudo-tumor cerebri), infection at the site of injection, lack of consent from the patient, patient refusal, true allergy to any drug used in the spine, and uncorrected hypovolemia.
    • Contraindications for ESP block procedure include: Infection at the site of injection, patient refusal, true allergy to any of the drugs used in the block, and lack of patient consent.
  • Any patient undergoing a laparoscopic abdominoperineal resection.

  • Any physical, mental or medical conditions which, in the opinion of the investigators, may confound quantifying postoperative pain resulting from surgery.

  • Known true allergy to the study medications (morphine, bupivacaine, decadron, Tylenol, Celebrex)

  • Takes over 30 mg of oral morphine equivalents daily

  • Any history of substance abuse in the past 6 months

  • End stage liver disease, end stage renal disease

  • Body weight of < 50 kg

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ESP BlockESP Blockan erector spinae plane (ESP) block in which bupivacaine and decadron are injected near the nerves under a muscle in the back.
IT InjectionIT Injectionan intrathecal (IT) injection in the back in which a small dose duramorph and bupivacaine will be placed into the spinal fluid
Primary Outcome Measures
NameTimeMethod
cumulated oral morphine equivalent (OME)24 hours after surgery

morphine consumption

Secondary Outcome Measures
NameTimeMethod
oral foodduration of hospital stay up to 72 hours

time to first oral food intake

first ambulationduration of hospital stay up to 72 hours

time to patient first ambulation

first flatusduration of hospital stay up to 72 hours

time to first flatus

patient's satisfaction scores48 hours after surgery

assess patient's satisfaction with care (1-10 with 1 being the least satisfied and 10 being the most satisfied)

opioid side effectsduration of hospital stay up to 72 hours

incidence of opioid side effects (nausea, pruritus, urinary retention, respiratory depression, ileus)

opioid consumption72 hours after surgery

opioid consumption in OME

Visual Analog Scale pain scores72 hours after surgery

pain scores using the Visual Analog Scale (0-10 with 0 being no pain and 10 being the worst pain)

hospital stayduration of hospital stay up to 7 days

amount of time each subject spends in the hospital before discharge

oral liquidduration of hospital stay up to 72 hours

time to first oral liquid intake

Trial Locations

Locations (1)

IU Health University Hospital

🇺🇸

Indianapolis, Indiana, United States

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