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Rectus sheath block (RSB) is a kind of anterior abdominal wall block. It has postoperative analgesic effect for abdominal surgery with midline incision. Robotic gynecologic surgery is accompanied by significant postoperative pain and usually IV-PCA is used to manage the pain.The purpose of this study is to investigate the analgesic effect of ultrasound-guided RSB to single-port robotic gynecologic surgery which has incision site at umbilical area. Patients will randomly assigned to two groups, RSB group and Control group. Each patients will assessed for time to first rescue analgesia, verbal numerical rating pain scores, number of rescue analgesic demands, and postoperatively opioids use by IV-PCA by a blinded investigator at 0, 1, 6, 12, 24 and 48 hours postoperatively.
Patients of RSB group will be performed ultrasound-guided bilateral RSB after induction of general anesthesia. The procedure will be performed bilaterally and 15 ml on each side, total 30 ml of 0.25% ropivacaine will be injected. After the procedure, a surgery scheduled will be proceeded. Patient of Control group will be proceeded the surgery after induction of anesthesia. All patients will use total 100 ml of IV-PCA containing 800 µg of fentanyl for 48 hours postoperatively. If a patient complains pain more intense than VNRS 4 or demands an analgesic drug, a rescue analgesic would be allowed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Rectus sheath block | Experimental | Patients of RSB group will be performed ultrasound-guided bilateral RSB after induction of general anesthesia. After draping the needle insertion site, a 22-gauge, 50-mm needle will be inserted medial to the probe by the in-plane technique and advanced in a lateral direction on just lateral to umbilicus. 15 ml of 0.25% ropivacaine will be injected on the posterior border of rectus muscle. This procedure will be performed bilaterally and total 30 ml of 0.25% ropivacaine will be injected. After the surgery, a bandage will be attached on injection site where is same as the incision site of surgery. All patients will use total 100 ml of IV-PCA containing fentanyl 800 µg for 48 hours postoperatively. |
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| Control | Sham Comparator | Patients of Control group will be proceeded a surgery scheduled after induction of general anesthesia without any procedure such as placebo injection. After the surgery, a bandage will be attached on the incision site where is same as the block injection site of RSB group. All patients will use total 100 ml of IV-PCA containing fentanyl 800µg for 48 hours postoperatively. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Rectus sheath block | Procedure | Ultrasound-guided bilateral rectus sheath block of RSB group using 0.25% Ropivacaine |
|
| Measure | Description | Time Frame |
|---|---|---|
| Verbal numerical rating scale | Postoperative pain on each time point which is expressed by verbal numerical rating scale (0 ~ 10) | 6 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Total opioids use | Total dosage of injected fentanyl through IV-PCA | 0, 1, 6, 12, 24, 48 hours postoperatively |
| Time to first rescue analgesic request | How long it takes postoperative time to first additional analgesic drug injection by patient's request |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Youn Jin Kim, MD, PhD | Ewha Womans University Mokdong Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ewha Womans University Mokdong Hospital | Seoul | 158-710 | South Korea |
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| ID | Term |
|---|---|
| D005831 | Genital Diseases, Female |
| ID | Term |
|---|---|
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D000091662 | Genital Diseases |
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| ID | Term |
|---|---|
| D000077212 | Ropivacaine |
| D001458 | Bandages |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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| Ropivacaine | Drug | Ultrasound-guided bilateral rectus sheath block of RSB group using 0.25% Ropivacaine |
|
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| Bandage | Other | After the surgery, a bandage will be attached on injection site where is same as the incision site of surgery. |
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| IV-PCA containing Fentanyl | Drug | All patients will use total 100 ml of IV-PCA containing 800 µg of fentanyl for 48 hours postoperatively. |
|
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| 48 hours postoperatively |
| Verbal numerical rating scale | Postoperative pain on each time point which is expressed by verbal numerical rating scale (0 ~ 10) | 0, 1, 12, 24, 48 hours postoperatively |
| D000588 |
| Amines |
| D004864 | Equipment and Supplies |