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Inability to recruit due to COVID situation and protocols
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Regional anesthesia, also know as a nerve block, is a key component of pain control after major abdominal surgery. Bilateral erector spinae plane block (ESPB) performed at low thoracic level has been shown to be an effective pain control method in case reports. This pilot study aims to further characterize the pain-control characteristics and to provide baseline data for future trials.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Erector spinae plane block | Experimental | The ESPB will be performed with ultrasound guidance. After identifying a suitable location between 8th and 10th thoracic spine transverse process, the overlying skin will be infiltrated with local anesthetic. A 22 gauge 90-mm needle will be inserted to make contact with the transverse process and withdraw slightly. Ropivacaine 0.5% 20 mL will be injected at this location. The same procedure will be performed on the other side. Additionally, patients will receive acetaminophen, gabapentin and intravenous patient-controlled analgesia opioids. |
|
| Shame block | Sham Comparator | A sham block will be performed by performing ultrasound examination of the back looking for intended location for ESPB placement. Skin will be infiltrated with local anesthetics but ESPB will not be performed. Additionally, patients will receive acetaminophen, gabapentin and intravenous patient-controlled analgesia opioids. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Erector spinae plane block | Procedure | Ropivacaine 0.5% 20 mL at each site of ESPB |
|
| Measure | Description | Time Frame |
|---|---|---|
| Opioid consumption | Postoperative opioid consumption in oral morphine equivalents | First 12 postoperative hour |
| Pain score | Numeric rating scale (0 - 10) for pain score, area under curve first 12 hours | First 12 postoperative hour |
| Measure | Description | Time Frame |
|---|---|---|
| Length of stay in post-anesthetic recovery unit | Length of stay in post-anesthetic recovery unit | until discharge from post-anesthetic recovery unit, up to 4 hours postoperaively |
| Length of stay in hospital |
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Inclusion Criteria:
Adult surgical patients who are American Society of Anesthesiologists (ASA) class I to III, undergoing cystectomy, or total abdominal hysterectomy, salpingo-oophrectomy with or without omentectomy via midline laparotomy.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Cheng Lin | Western University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cheng Lin | London | Ontario | n6c6a7 | Canada |
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Sham block will be performed
| Sham block | Procedure | Skin infiltration only |
|
Length of stay in hospital
| until discharge from hospital, up to 7 days postoperatively |
| Number of participants with opioid related complication | Nausea, vomiting, pruritus | Until discharge, up to 7 days postoperatively |
| Number of participants with block related complication | Hematoma, nerve deficit, pneumothorax | Until discharge, up to 7 days postoperatively |
| Pain score 12 - 24 hour | Area under curve of Numeric rating scale(0 - 10) pain score during the 12 to 24th postoperative hour | 12th to 24th postoperative hour |
| Opioid consumption 12 - 24 hour | Postoperative opioid consumption in oral morphine equivalents | 12th to 24th postoperative hour |