Bilateral External Oblique Intercostal Plane Block Versus Patient Controlled Analgesia (PCA) in Post Operative Pain Management in Hepatectomy Surgery.
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Enrollment
- 40
- Primary Endpoint
- • Rescue morphine consumption in both groups. (Total consumption of morphine rescue shots in milligram in first 2r hours)
Study Overview
Brief Summary
The majority of cases undergoing hepatectomy suffer from inadequate postoperative analgesia. Therefore, multimodal analgesic techniques are required to relieve pain and discomfort such as intravenous, and epidural analgesia, and peripheral nerve blocks. Although epidural catheters are efficient to provide perioperative analgesia, in this type of surgery patients may be more susceptible to catheter related complications due to the alteration in coagulation parameters. That is why safer alternatives are sought for those patients. The use of patient-controlled analgesia (PCA) for postoperative pain management improves patients' quality of recovery. However, there are many concerns regarding the type of opioids used in PCA such as overdosing, underdosing, and the effect of the hepatectomy on the drug metabolism in those patients. External oblique intercostal plane block (EOI block) is a relatively novel block used in upper abdominal incisions especially subcostal laparotomy to provide intraoperative and postoperative analgesia.
This study aims to compare the efficacy of Bilateral External Oblique Intercostal Plain Block versus PCA in pain management and reduction of opioid use in hepatectomy surgery done by subcostal incision.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Supportive Care
- Masking
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age ≥ 18 and ≤ 65 Years.
- •Both sexes.
- •Patients will be scheduled for hepatectomy surgery.
- •Body mass index (BMI) 18.5-30.0 /m 2 .
Exclusion Criteria
- •Extension of the surgical incision beyond coverage of T12 dermatome.
- •Prolonged time of surgery > 5 hours.
- •Hepatectomy surgery combined with another organ resection.
- •Patients with hypersensitivity to local anesthetics.
- •History of psychiatric problems.
- •Recent history of analgesic drugs including opioid abuse or addiction.
- •Coagulopathy (International normalized ratio [INR] > 1.4).
- •Localized infection at the block site.
- •Morbidly obese patients.
Arms & Interventions
External Oblique Intercostal Plane block
Patients in this group will receive External Oblique Intercostal plane block intraoperatively before the surgery.
Intervention: External Oblique Intercostal Plane Block (Procedure)
Patient controlled analgesia
Patient will be on patient control analgesia after the surgery.
Intervention: Patient controlled analgesia (Device)
Outcomes
Primary Outcomes
• Rescue morphine consumption in both groups. (Total consumption of morphine rescue shots in milligram in first 2r hours)
Time Frame: twenty four hours.
Secondary Outcomes
No secondary outcomes reported
Investigators
Sherif Alaa Embaby
Consultant of Anaesthesia, ICU and pain management.
Kasr El Aini Hospital