NCT Number: NCT07055438
The current study is designed to investigate the analgesic potentials of two modalities of abdominal blocks where local anesthetics is injected in the fascial planes of the abdominal muscles to anesthetize the nerves supplying the abdomen in patients undergoing upper abdomial surgeries.
the two modalities are the rectus sheath block (RSB) and the external oblique intercostal plane block (EOIPB). The investigators are going to use the ultrasound to identify the muscles and inject the local anesthetics. The investigators suggest that the EOIPB might provide better pain control when compared to RSB.
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Notify Me18 year–65 year
All sexes
Interventional
Not applicable
Kasr El Ainy, Cairo, Egypt
Fascial plane blocks emerge as an appealing technique to provide good intraoperative and postoperative analgesia in patients undergoing upper abdominal surgeries. Such techniques have the benefit of decreasing opioids use and consequently reducing the like hood of their side effects.
Ultrasound guided rectus sheath Block (RSB) targets the terminal branches of thoracic nerves thus providing analgesia for midline abdominal incisions.
Ultrasound guided external oblique intercostal plane block (EOIPB), a relatively new technique, targets the lateral cutaneous branches of the thoracoabdominal nerves providing analgesia for anterolateral and upper median plane of the abdomen.
Studies Comparing both techniques are deficient, that is why the investigators designed the current study to evaluate and compare the analgesic efficacy of both techniques in upper abdominal surgeries namely Whipple operation and total gastrectomy.
The study is a randomized controlled double blinded trial comprising two groups. The RSB group will receive bilateral ultrasound guided rectus sheath block with 20ml of 0.25% bupivacaine on each side. The EOIB group will receive bilateral ultrasound guided External oblique intercostal plane block with 20ml of 0.25% bupivacaine on each side as well. Both blocks will be performed after administering general anesthesia.
The main endpoint of the study is the time to first request for rescue analgesia.
Healthy volunteers accepted: No
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Exclusion criteria
After receiving general anesthesia, bilateral ultrasound guided rectus sheath block with 20 ml of 0.25% bupivacaine on each side will be administered to 20 patients undergoing upper abdominal surgeries namely whipple operation and total gastrectomy
After receiving general anesthesia, bilateral ultrasound guided external oblique intercostal plane block with 20 ml of 0.25% bupivacaine on each side will be administered to 20 patients undergoing upper abdominal surgeries namely whipple operation and total gastrectomy
Time frame: Time in hours from end of surgery to first dose of morphine administered up to 24 hours postoperatively
Time from end of surgery to first dose of morphine administered
Time frame: From the start of the surgery till the end in micogram/Kg
Intraoperative fentanyl consumption
Time frame: from the time numerical rating scale exceeds 3 and till 24 hours after the end of the surgery
Total morphine consumption (mg) in the first 24hrs after surgery
Time frame: from the time of recovery immediately in the postoperative period and then at 30 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 12 hours and 24 hours postoperatively
Pain score using Numerical rating Scale (NRS)between 0 and 10, Zero means no pain and ten means the worst pain
Time frame: 2 hours after recovery from anesthesia
Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied ; 5, extremely satisfied)
Time frame: From the recovery of anesthesia and up to 24 hours postoperatively
The number of patients suffering from postoperative nausea and vomiting in both groups
Kasr El Aini Hospital
Other
Analgesic Efficacy of Ultrasound Guided Bilateral External Oblique Intercostal Plane Block Versus Rectus Sheath Block in Upper Abdominal Surgeries: A Randomized Double-blinded Controlled Study
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