The Effect of Upper Transabdominal Plain Block on Diaphragm Thickness

Completed

• Conditions: Anesthesia, General
• Interventions: Diagnostic Test: Ultrasound measurement

• Registration Number: NCT04997655
• Lead Sponsor: Konya City Hospital

Brief Summary

In the study, patients of both sexes between the ages of 18 and 60 who will undergo laparoscopic cholecystectomy will be examined. In this patient group, the change in the inspiratory and expiratory diaphragmatic thickness before and after laparoscopic cholecystectomy operation in the upper transabdominal block group will be examined.

Detailed Description

The use of ultrasonography (USG) in operating rooms is increasing day by day. Diaphragm thickness can be evaluated by ultrasonography and is used as a bedside method studies have proven that the evaluation of diaphragmatic thickness contributes to the observation of diaphragmatic function and the evaluation of respiratory workload. Measurement of diaphragmatic thickness is a method used in operating rooms and intensive care units to make the decision to wean from mechanical ventilation and extubation. Laparoscopic gallbladder operations are a very common operation in the adult age group in the operating room. In these cases who were intubated and extubated at the end of the operation, regression in respiratory function is observed, especially due to right upper quadrant pain appropriate to the location of the liver. For this reason, the respiratory functions of patients who will have gallbladder surgery will be routinely evaluated before and after gallbladder surgery in our clinic with the help of USG and routinely apply analgesic methods, including peripheral nerve blocks, to patients with pain.

In this study, it will be planned to observe the effect of upper transabdominal area block, which is routinely performed post-operatively in laparoscopic gallbladder operations, on diaphragmatic thickness and therefore on respiratory capacity, and observationally evaluating diaphragmatic thickness measurements by USG, which is routinely performed post-operatively and the measurement records are noted.

Study Timeline

• Study First Submitted: 2021-07-25
• Study First Submitted QC: 2021-08-05
• Study First Posted: 2021-08-09
• Study Start: 2022-06-02
• Primary Completion: 2022-09-01
• Status Verified: 2023-03
• Study Completion: 2023-03-18
• Last Update Submitted: 2023-03-19
• Last Update Posted: 2023-03-21

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 67

Inclusion Criteria

• Patients between the ages of 18-60
• Both sexes
• Patiets are evaluated as ASA 1 and ASA 2 anesthesia risk, will be examined.

Exclusion Criteria

• Under 18 years old, over 60 years old
• BMI>35 kg/m2
• Bleeding diathesis
• Local anesthetic allergy
• Infection in the area of TAP (Trans abdominal plane) block application
• Illiteracy, communication problem
• Previous upper abdomen operation
• Transition to open surgery Cases
• Severe chronic respiratory disease
• Neuromuscular disorders.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Upper Transabdominal Plain Block	Ultrasound measurement	All patients in this group are routinely administered general anesthesia. After extubation, the subcostal transverse abdominis area block was directed laterally along the rectus abdominis muscle by finding the linea alba under the xiphoid region under ultrasound guidance with a 22G echogenic block needle, and 20 ml (8 ml 0.5% bupivacaine, 7 ml prilocaine) into the fascia between the rectus abdominis and transverse abdominis muscles. , 5 ml of saline) drug mixture will be performed by the anesthesiologist in charge of that day, who is not aware of the observational measurement to be made, if there is an indication, as a blind practitioner.
Opioid analgesia	Ultrasound measurement	All patients in this group are routinely administered general anesthesia. Apart from this, in the other group, which does not have peripheral nerve block and only routine opioid analgesia is considered sufficient, only routine peroperative USG diaphragm measurements will be recorded observationally.

Primary Outcome Measures

Name	Time	Method
Diaphragm Thickness	5 minutes after upper abdominal plane block	The measurement of Diaphragm Thickness by USG

Secondary Outcome Measures

Name	Time	Method
Oxygen saturation	Before the anesthesia, after anesthesia and after 30 minutes in the post operative care unit.	Oxygen saturation separately for each primary outcome stage
Visual analogue scale	Before the anesthesia, after anesthesia and after 30 minutes in the post operative care unit.	The patient's pain will be asked in a scale from 1 to 10.

Trial Locations

Locations (1)

Yasin Tire; 🇹🇷 Konya, Meram, Turkey