The Effect of Ultrasound Guided External Oblique and Rectus Abdominis Plane Block (EXORA) on Neuroendocrine Stress Response in Adults Undergoing Umbilical Hernia Surgery: A Prospective Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- Tanta University
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- Neuroendocrine stress response
Overview
Brief Summary
This study aims to evaluate the efficacy of ultrasound-guided external oblique and rectus abdominis plane block on the neuroendocrine stress response and postoperative analgesia in adults undergoing umbilical hernia repair.
Detailed Description
Umbilical hernias of the abdomen are defined as a non-inguinal, non-hiatal defect in the fascia of the abdominal wall. Surgical stress response refers to the physiologic response to surgery and the hormonal and metabolic changes that follow it.
Fascial plane blocks are gaining attention for perioperative analgesia due to their efficacy and safety profiles. The external oblique and rectus abdominis plane (EXORA) block is an emerging technique that provides a sensory block to the anterolateral abdominal wall, potentially filling gaps left by other commonly used blocks, such as the quadratus lumborum (QLB) or erector spinae plane (ESP) blocks.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Double (Participant, Outcomes Assessor)
Eligibility Criteria
- Ages
- 21 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Aged from 21 to 65 years.
- •Both sexes.
- •American Society of Anesthesiologists (ASA) Physical status I and Ⅱ.
- •Schedule for elective umbilical hernia surgery under general anesthesia.
Exclusion Criteria
- •ASA Ⅲ or Ⅳ.
- •Patients with metabolic abnormalities, e.g., diabetes mellitus.
- •Patients receiving corticosteroids.
- •History of allergies to local anesthetics.
- •Bleeding or coagulation disorders.
- •Anatomical abnormalities.
- •Psychiatric and neurological disorders.
- •Complicated hernial defect (obstructed).
- •Patient refusal.
Outcomes
Primary Outcomes
Neuroendocrine stress response
Time Frame: 24 hours postoperatively
Neuroendocrine stress response will be measured by blood glucose level in adults undergoing umbilical hernia repair.
Secondary Outcomes
- Serum cortisol level(24 hours postoperatively)
- Time of first rescue analgesia(24 hours postoperatively)
- Total intraoperative fentanyl consumption(Intraoperatively)
- Total morphine consumption(24 hours postoperatively)
- Degree of pain(24 hours postoperatively)
Investigators
Mayada Hady Mahmoud Sokeer
Assistant Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine, Tanta University, Tanta, Egypt.
Tanta University