Erector Spinae Plan Block for Postoperative Analgesia
- Conditions
- Postoperative Pain
- Interventions
- Procedure: Erector Spinae Plan BlockProcedure: Oblique subcostal TAP
- Registration Number
- NCT03398564
- Lead Sponsor
- Al Jedaani Hospital
- Brief Summary
Laparoscopic cholecystectomy is a widely employed procedure in ambulatory surgery. Pain after laparoscopic cholecystectomy arises significantly from port site incisions in the anterior abdominal wall. Innervation of the anterior abdominal wall is segmentally supplied by pain afferents in the plane of fascia between transversus abdominis and the internal oblique muscles. Opioids analgesia is used to control postoperative pain, but it carries the risk of increased nausea and vomiting, ileus and sedation that may delay hospital discharge.
Several techniques have been tried as.neuroaxial narcotics, intraperitoneal lavage of local anesthetic and transversus abdominis plan (TAP) block and successfully reduced opioid use and improve postoperative analgesia.
The ultrasound-guided erector spinae plan(ESP) block is a recently described technique which produces reliable unilateral analgesia at thoraco-lumbar dermatomes. ESP block carries the advantages of being simple, safe, easily recognizable by ultrasound, and a catheter can be threaded to extend the duration of analgesia.
Few case series reported the efficacy of (US)-guided ESP blocks in reducing postoperative pain and opioids consumption.
Because of that, the investigators aimed to test the hypothesis that US-guided ESP blocks can decrease opioid consumption during the first 24 h after of laparoscopic cholecystectomy in comparison with the conventional systemic analgesia.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 70
- 60 ASA I- II adult patients
- 20-60 years old
- elective laparoscopic cholecystectomy
- Body mass index (BMI) less than 35
- Port sites at or above thoracic T 10 dermatome
- Allergy to amino-amide local anesthetics
- Presence of coagulopathy
- Local skin infection at the needle puncture sites
- Preoperative chronic dependence upon opioid and NSAID medications
- Liver or renal insufficiency
- History of psychiatric or neurological disease
- Deafness
- previous open surgery that need the conversion of laparoscopic to open surgery or manipulations more than expected with more tissue trauma
- American Society of Anesthesiologists (ASA) above Class II
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Group I (Control) Erector Spinae Plan Block ultrasound guided Bilateral Erector Spinae Plan Block using isotonic saline Group II (ESP) Erector Spinae Plan Block ultrasound guided Bilateral Erector Spinae Plan Block with bupivacaine 0.25% Group III(OSTAP) Oblique subcostal TAP Ultrasound-guided bilateral oblique subcostal TAP block
- Primary Outcome Measures
Name Time Method Morphine consumption 24 hours postoperatively. It was calculated as equivalent morphine dose to the opioid analgesia consumed
- Secondary Outcome Measures
Name Time Method Quality of analgesia Every 2 hours for 24 hours postoperatively comparing visual analog scores (VAS) every two hours after surgery
Erector spinae plan block complications 24 hours postoperative local anesthetic systemic toxicity, vascular injury, and intravascular injection of local anesthetic
The intraoperative fentanyl 2 hours (µg) required during surgery
equivalent morphine dose in the recovery unit (PACU) one hour equivalent morphine dose in the recovery unit (PACU)
Trial Locations
- Locations (1)
Al Jedaani group of hospitals
🇸🇦Jeddah, Meccah, Saudi Arabia