Efficacy of Intraoperative Superior Hypogastric Plexus Blockade for Postoperative Pain in Laparoscopic Hysterectomy
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- postoperative pain scores (PACU)
研究概览
简要总结
The primary indication for superior hypogastric plexus (SHP) block is visceral pelvic pain, most commonly from malignancy of the ovary, uterus, cervix, bladder, rectum or prostate. Per-cutaneous SHP blocks should be done under guidance of ultrasonography, fluoroscopy, magnetic resonance or computed tomography. During minimally invasive laparoscopic surgery, percutaneous technique can be done under the guidance of cameras.
详细描述
Laparoscopic surgeries have many advantages over open surgeries. Laparoscopic procedures are mostly preferred for surgical treatment of gynecologic diseases, because of best cosmetically results, less perioperative complications, early recovery, and less postoperative pain.
There are many undesirable effects of systemic reactions to the pain. Accordingly, multi-modal analgesic approach (including nerve blocks) for postoperative acute pain can decrease the side effects of the drugs (especially opioids) significantly.
The primary indication for superior hypogastric plexus (SHP) block is visceral pelvic pain, most commonly from malignancy of the ovary, uterus, cervix, bladder, rectum or prostate. Per-cutaneous SHP blocks should be done under guidance of ultrasonography, fluoroscopy, magnetic resonance or computed tomography. During minimally invasive laparoscopic surgery, per-cutaneous technique can be done under the guidance of cameras.
SHP block has been performed by anesthetists or surgeons in Kocaeli Derince Training and Research Hospital regularly since they have discovered the advantages of this block technique. SHP can be useful to decrease postoperative pain scores and opioid or NSAID consumption significantly.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •ASA I - II
- •Elective laparoscopic hysterectomy
排除标准
- •Different kind of surgery
- •Known allergy to local anesthetic drugs
- •Different analgesia protocol (ie: epidural, TAP block,..)
- •Refusal of the patient
结局指标
主要结局
postoperative pain scores (PACU)
时间窗: 1 hour (postoperatively)
Patients' pain scores will be scored with a 10 cm Visual Analogue Scale (VAS). Each will be scored between 0-10 (0: no pain; 10: worst pain ever)
postoperative opioid/NSAID consumption (PACU)
时间窗: 1 hour (postoperatively)
nonsteroid antiinflammatory drugs (NSAID) or opioid drugs that are applied to patients will be noted down.
rescue analgesic time
时间窗: 48 hours (first analgesic demand time will be noted down)
Time to first analgesic demand at gynecology ward (after transfer from PACU to gynecology ward)
postoperative pain scores (ward)
时间窗: 48 hours (postoperatively)
Patients' pain scores will be scored with a 10 cm Visual Analogue Scale (VAS). Each will be scored between 0-10 (0: no pain; 10: worst pain ever)
postoperative opioid/NSAID consumption (ward)
时间窗: 48 hours (total)
NSAID or opioid drugs that are applied to patients will be noted down. Target VAS score for NSAID is \>4; if there is no response to NSAID and pain is worsening opioid drugs will be applied
次要结局
- Intraoperative hemodynamics(from SHP block to the end of the surgery (approximately 15 min))
- length of stay(3-5 days (expected))
- complications due to SHP block(3-5 days (from surgery to discharge from the hospital))
研究者
Hande G. Aytuluk
M.D., Principal investigator
Derince Training and Research Hospital