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To compare the efficacy of USG-guided bilateral External oblique intercostal (EOI) block with Erector spinae plane block (ESPB) for post-operative analgesia after laparoscopic cholecystectomy with a hypothesis that both External oblique intercostal fascial plane block and Erector spinae plane block are effective in providing post-operative analgesia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| External oblique intercostal (EOI) block | Active Comparator |
| |
| Erector spinae plane block (ESPB) | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| External oblique intercostal (EOI) block | Other | A high-frequency linear ultrasound probe will be placed in a longitudinal parasagittal orientation at the sixth intercostal space in the anterior midaxillary line. A 21G 10 cm needle will be inserted using an in plane approach. The tip of the needle will be placed into the fascial plane on the deep aspect of the external oblique muscle. A volume of 20 mL of LA mixture (10 mL of bupivacaine 0.5%, 5 mL of lidocaine 2% and 5 mL of normal saline to make a mixture totaling 20 ml.) will be injected. The same procedure will be repeated for the opposite side. |
| Measure | Description | Time Frame |
|---|---|---|
| Nalbuphine consumption in mg equivalent to morphine dose. | mg | 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Numerical Rating Scale (NRS) at rest and when coughing | 11-point scale where 0=no pain and 10=worst pain | at 1, 2,4 , 8, 16 and 24 hours postoperatively |
| Analgesic drug consumption other than nalbuphine |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Magdy M mahdy, MD | Contact | 0109 650 2058 | magdymahdy84@yahoo.com | |
| Amr M.A. Thabet, MD | Contact | 01068924262 | Amrthabet@aun.edu.eg |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Assiut University hospital | Recruiting | Asyut | Assiut, Asyut Governorate, Egypt, | Egypt |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| ID | Term |
|---|---|
| D003766 | Dental Occlusion |
| ID | Term |
|---|---|
| D003813 | Dentistry |
| D009063 | Dental Physiological Phenomena |
| D055688 | Digestive System and Oral Physiological Phenomena |
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triple
|
| Erector spinae plane block (ESPB) | Other | A high-frequency linear ultrasound probe will be placed in a longitudinal parasagittal orientation 2.5-3 cm lateral to the T9 spinous process. The erector spinae muscles will be identified superficial to the tip of the T9 transverse process. A 21G 10 cm needle will be inserted using an in plane approach. The tip of the needle will be placed into the fascial plane on the deep aspect of the erector spinae muscle. The location of the needle tip will be confirmed by visible fluid spread lifting the erector spinae muscle off the bony shadow of the transverse process on ultrasonographic imaging. A volume of 20 mL of Local Anesthetic mixture (10 mL of bupivacaine 0.5%, 5 mL of lidocaine 2% and 5 mL of normal saline to make a mixture totaling 20 ml.) will be injected. The same procedure will be repeated for the opposite side. |
|
in mg
| 24 hours postoperatively |
| Heart Rate | beats /min | Intraoperatively at 0, 5,10, 20, and 30 minutes. Then every 15 min thereafter till the end of surgery |
| Mean Arterial Pressure | mmHg | Intraoperatively at 0, 5,10, 20, and 30 minutes. Then every 15 min thereafter till the end of surgery |
| Incidence of Postoperative nausea & vomiting (PONV) | Number of patients developing PONV | 24 hours postoperatively |
| Shoulder pain | Number of patients developing Shoulder pain | 24 hours postoperatively |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |