Impact of Ultrasound-Guided Transversus Abdominis Plane Block on Postoperative Nausea and Vomiting and Early Outcome After Laparoscopic Bariatric Surgery: a Randomized Double-Blinded Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Normal saline
- Conditions
- Postoperative Nausea and Vomiting
- Sponsor
- Tianjin Medical University General Hospital
- Enrollment
- 90
- Primary Endpoint
- Postoperative nausea and vomiting
- Last Updated
- 4 years ago
Overview
Brief Summary
To explore and compare Ultrasound-Guided Transversus Abdominis Plane Block on Postoperative nausea and vomiting and Early Outcome After Laparoscopic Bariatric Surgery To evaluate and examine TAPB can reduce the application of intraoperative and postoperative opioids and the duration of analgesia
Detailed Description
Poor postoperative nausea and vomiting control is a leading factor that hinders the physical rehabilitation, and causes acute cognitive impairment and chronic pain syndrome. Recently, the multimodal analgesia strategies to minimise opioid-related side effects are highly desirable in open surgical procedures. The transversus abdominis plane block is a novel technique involving injection of local anaesthetic between the internal oblique and the transversus abdominis muscles of the abdominal wall. Although ropivacaine is most commonly used for this technique, the analgesic duration remains not dissatisfied. Herein, investigators will evaluate the efficacy of ultrasound-guided transversus abdominis plane(USG- TAP) block with ropivacaine in Laparoscopic Bariatric Surgery.
Investigators
Guolin Wang
Professor
Tianjin Medical University General Hospital
Eligibility Criteria
Inclusion Criteria
- •Subject is scheduled to undergo Laparoscopic Bariatric Surgery
- •Subject's American Society of Anesthesiologists physical status is I-III.
- •BMI\>35kg/m2
- •The subject's parent/legally authorized guardian has given written informed consent to participate
Exclusion Criteria
- •Subject has a diagnosis of renal or liver failure.
- •Subject has a diagnosis of mental illness
- •Subject is allergy and contraindication to Ropivacaine.
- •Subject has a history of chronic pain, a history of alcohol or opioid abuse, pre-existing therapy with opioids, intake of any analgesic drug within 48 hours before surgery.
- •Subject has any contraindication for the use
- •Subject is pregnant or breast-feeding.
Arms & Interventions
Normal Saline
Before the induction of anesthesia, normal saline is used for bilateral transversus abdominis plane block in a volume of 20 mL of each side.
Intervention: Normal saline
Ropivacaine at high concentration
Before the induction of anesthesia, 0.375% Ropivacaine is used for bilateral transversus abdominis plane block in a volume of 20 mL of each side
Intervention: Ropivacaine at high concentration
Ropivacaine and dexamethasone
Before the induction of anesthesia, 0.375% Ropivacaine and 5.0mg dexamethasone are used for bilateral transversus abdominis plane block in a volume of 20 mL of each side
Intervention: Ropivacaine and dexamethasone
Outcomes
Primary Outcomes
Postoperative nausea and vomiting
Time Frame: 72 hours after surgery
The Apfel score was recorded for evaluating risk for developing postoperative nausea and vomiting (PONV).
Secondary Outcomes
- cumulative Sufentanyl Consumption during surgery(during surgery)
- Mean time until passage of flatus(72 hours after surgery)
- Diffusion area of local anesthetics after transversus abdominis plane block(30 minutes after transversus abdominis plane block)
- Time of First Postoperative Analgesic Requiremen(1hour after surgery)
- Apfel score(The 1 day before the surgery)
- The incidence of Side Effects(48 hours after surgery)
- Total Dose of First Postoperative Analgesic Requirement(1hour after surgery)
- cumulative Sufentanyl Consumption after surgery(48 hours after surgery)
- Time to ambulation(12 hours after surgery)
- Normalized Area of Hyperalgesia Around the Incision(48 hours after surgery)