External Oblique Intercostal Plane Block Versus Ultrasound Guided Transversus Abdominis Plane Block for Postoperative Analgesia in Adult Patients Undergoing Open Nephrectomy
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- External Oblique Intercostal Plane Block
- Sponsor
- Tanta University
- Enrollment
- 40
- Locations
- 1
- Primary Endpoint
- Total pethidine consumption in the 1st 24hr
- Status
- Completed
- Last Updated
- 5 months ago
Overview
Brief Summary
The aim of this study is to compare external oblique intercostal plane (EOIP) block and ultrasound guided transversus abdominis plane (TAP) Block for postoperative analgesia in adult patients undergoing open nephrectomy.
Detailed Description
Patients undergoing nephrectomy have a high incidence of postoperative pain despite the use of modern laparoscopic surgical techniques. In the postoperative period, these patients are often treated with patient-controlled opioids, epidural analgesia, or both. Ultrasound-guided transversus abdominis plane (TAP) block is a relatively new technique to infiltrate regional anesthesia in which local routine anesthetics are injected between the internal oblique and transverse abdominal muscles. Studies have confirmed that ultrasound-guided (USG) transversus abdominis plane (TAP) block is an effective method of analgesia for upper abdominal surgeries, lower abdominal surgeries, and kidney transplantation, with minimal side effects. External oblique intercostal plane block (EOIPB) has been reported by Elsharkawy et al. in 2021 as a significant modification of fascial plane blocks in that it may engage the upper lateral abdominal walls consistently. In comparison to quadratus lumborum block (QLB) and erector spinae plane block (ESPB) , The advantage of EOIPB is that it may be performed with the patient supine. Furthermore, in comparison to serratus intercostal plane block (SIPB), it generates more extensive analgesic effects throughout the whole midline of the abdomen .
Investigators
Mohammed Said ElSharkawy
Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Tanta University
Eligibility Criteria
Inclusion Criteria
- •Age ≥ 18 years.
- •Both sexes.
- •American Society of Anesthesiology (ASA) physical status I-II.
- •Scheduled for open nephrectomy.
Exclusion Criteria
- •Bleeding disorders.
- •Skin lesions or infection at the site of proposed needle insertion.
- •Allergy to local anesthetics.
- •Neurological disorders.
- •Drug abuse.
- •BMI \> 30 kg/m
- •Pregnancy.
- •Diabetic neuropathy.
- •Severe cardiovascular problems.
Outcomes
Primary Outcomes
Total pethidine consumption in the 1st 24hr
Time Frame: 24 hours postoperatively
A standardized analgesic regimen will be prescribed in the postoperative period. All patients will receive paracetamol 1 gm every 6 h as routine analgesia. Rescue analgesia of pethidine will be given as 2 mg bolus if the Numerical Rating Scale (NRS) \> 3 to be repeated after 30 min if pain persists until the Numerical Rating Scale (NRS) \< 4. NRS will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively.
Secondary Outcomes
- Mean arterial pressure(Every 15 minutes till the end of surgery)
- Intraoperative fentanyl consumption(Intraoperatively)
- Heart rate(Every 15 minutes till the end of surgery)
- Time to the 1st rescue analgesia.(24 hours postoperatively)
- Degree of pain(24 hours postoperatively)